Basic Information
Provider Information
NPI: 1386862159
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STYRON
FirstName: JAMES
MiddleName: CLYDE
NamePrefix:  
NameSuffix: IV
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1241 N MAIN ST
Address2:  
City: HARRISONBURG
State: VA
PostalCode: 228024632
CountryCode: US
TelephoneNumber: 5404341941
FaxNumber:  
Practice Location
Address1: 1241 N MAIN ST
Address2:  
City: HARRISONBURG
State: VA
PostalCode: 22802
CountryCode: US
TelephoneNumber: 5404341941
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/24/2007
LastUpdateDate: 01/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X0101245047VAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

ID Information
IDTypeStateIssuerDescription
138686215905VA MEDICAID


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