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General NPI Number Information
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NPI Number | 1821257957
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Entity Type | Individual
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Provider Name | JAMES ROBERT JASTIFER MD
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Gender | Male
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 2310 CALIFORNIA RD
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City | ELKHART
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State | IN
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Zip | 46514-1228
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Country | US
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Telephone | 574-264-0791
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Fax |
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Provider Business Mailing Address
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Address Line | 2490 S 11TH ST
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City | KALAMAZOO
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State | MI
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Zip | 49009-2175
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Country | US
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Telephone | 269-343-1535
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301092041
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | M-12054
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 01093180A
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License Number State | IN
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