Basic Information
| Provider Information | |||||||||
| NPI: | 1538455720 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STIENECKER | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 BELLEFONTAINE AVE | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458042800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199984575 | ||||||||
| FaxNumber: | 4199984586 | ||||||||
| Practice Location | |||||||||
| Address1: | 1003 BELLEFONTAINE AVE STE 150 | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458041871 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199988295 | ||||||||
| FaxNumber: | 4192268323 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2011 | ||||||||
| LastUpdateDate: | 04/06/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 54259 | CO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | 34.010695 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 208D00000X | 34.010695 | OH | N | Allopathic & Osteopathic Physicians | General Practice | 207RP1001X | 34.010695 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.