Healthcare Provider Details

I. General information

NPI: 1861548414
Provider Name (Legal Business Name): JAMES EDWARD ESCHITI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W GORE BLVD STE A
LAWTON OK
73501-3629
US

IV. Provider business mailing address

1201 W GORE BLVD STE A
LAWTON OK
73501-3629
US

V. Phone/Fax

Practice location:
  • Phone: 580-353-6776
  • Fax: 580-353-1214
Mailing address:
  • Phone: 580-353-6776
  • Fax: 612-728-5859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4155
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: