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B C STUFFLEBAM, MD, LLC
NPI 1043453707
Radiology - Diagnostic Radiology in Centralia, IL

Active since April 10, 2009
629 SABLE DR, CENTRALIA, IL 62801(618) 533-0727(618) 533-1464 Get Directions Write a Review

NPPES record last updated: April 10, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About B C Stufflebam, Md, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

B C STUFFLEBAM, MD, LLC (NPI 1043453707) is a healthcare organization registered as a diagnostic radiology in Centralia, Illinois and active in the NPI registry since April 2009. The organization lists Bradley Christian Stufflebam, Manager, as its authorized official.

NPPES Registry Identity

NPI1043453707
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameB C STUFFLEBAM, MD, LLC
Location Address629 SABLE DRCentralia, IL 62801-4472
Mailing Address629 Sable DrCentralia, IL 62801-4472 · (618) 533-0727 · Fax (618) 533-1464
Phone(618) 533-0727
Fax(618) 533-1464
Organization SubpartNo
Authorized OfficialBradley Christian StufflebamManager · (618) 533-0727
Enumeration DateApril 10, 2009
✔ NPI 1043453707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in IL · 036058847
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
629 SABLE DR, Centralia, IL 62801
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Other Identifiers 1

Medicare UPINC42550

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRADLEY C STUFFLEBAM M.D.
Radiology (Diagnostic Radiology)
629 SABLE DR
CENTRALIA, IL 62801
Marion County (618) 533-0727

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is B C Stufflebam, MD, LLC's NPI number?

The NPI number for B C Stufflebam, MD, LLC is 1043453707. It was assigned to this organization in the NPPES registry on April 10, 2009.

Where is B C Stufflebam, MD, LLC located?

B C Stufflebam, MD, LLC is located at 629 Sable Dr, Centralia, IL 62801. The listed phone number is (618) 533-0727.

What is B C Stufflebam, MD, LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for B C Stufflebam, MD, LLC was last updated on April 10, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.