Provider Demographics
NPI:1962589531
Name:STERN, JASON ERIC (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:ERIC
Last Name:STERN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 MAZUREK BLVD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-3974
Mailing Address - Country:US
Mailing Address - Phone:850-375-9822
Mailing Address - Fax:850-438-7077
Practice Address - Street 1:5505 N W ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-2435
Practice Address - Country:US
Practice Address - Phone:850-435-9200
Practice Address - Fax:850-435-9922
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9120111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
051531431STEMedicare ID - Type Unspecified
VO7350Medicare UPIN