Healthcare Provider Details
I. General information
NPI: 1134154925
Provider Name (Legal Business Name): JAMES WADE DOWNING D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/11/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
105 E VANDAMENT AVE
YUKON OK
73099-4706
US
IV. Provider business mailing address
16941 PRAIRIE CIR
EL RENO OK
73036-9107
US
V. Phone/Fax
- Phone: 405-354-0994
- Fax: 405-354-0995
- Phone: 405-324-6890
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 3145 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: