Provider Demographics
NPI:1447269279
Name:STUBBLEFIELD, LEWIS CALVIN (DC)
Entity type:Individual
Prefix:MR
First Name:LEWIS
Middle Name:CALVIN
Last Name:STUBBLEFIELD
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 1:870 W ONSTOTT RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3550
Mailing Address - Country:US
Mailing Address - Phone:530-674-2803
Mailing Address - Fax:530-674-2859
Practice Address - Street 1:870 W ONSTOTT RD
Practice Address - Street 2:SUITE G
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3550
Practice Address - Country:US
Practice Address - Phone:530-674-2803
Practice Address - Fax:530-674-2859
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA016547111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0165470Medicare ID - Type Unspecified
T06181Medicare UPIN