MEDICARE: JEFFREY AARON JAMES DO

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
1	207QS0010X	Sports Medicine (Family Medicine) Physician	34.011135	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700142734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY AARON JAMES DO

Provider Business Mailing Address
First Line	:	3170 KETTERING BLVD BLDG B3
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-1924
Country	:	US
Telephone Number	:	937-991-3188
Fax Number	:	937-223-9811

Provider Business Practice Location Address
First Line	:	2350 MIAMI VALLEY DR STE 320A
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-4778
Country	:	US
Telephone Number	:	937-312-1661
Fax Number	:	937-312-1701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2012
Last Update Date	:	05/11/2026

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