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NPI Code Detail

MEDICARE: MRS. JAYME LYNN STINE MD

MEDICARE: MRS. JAYME LYNN STINE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2208000000XPediatrics Physician036.147063IL

General Provider Information

NPI Number : 1699161448
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAYME LYNN STINE MD
Provider Business Mailing Address
First Line : 3333 BURNET AVENUE
Second Line : ML 5018
City : CINCINNATI
State : OH
Zip : 45229-3039
Country : US
Telephone Number : 740-636-4315
Fax Number : 513-636-7905
Provider Business Practice Location Address
First Line : 3517 W ARTHINGTON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4165
Country : US
Telephone Number : 872-588-3510
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2015
Last Update Date : 02/08/2019

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