=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689775827
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMES B. DOTY, D.C., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2006
-----------------------------------------------------
Last Update Date | 12/22/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3730 S NOLAND RD
-----------------------------------------------------
City | INDEPENDENCE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64055-3343
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-833-1232
-----------------------------------------------------
Fax | 816-833-4367
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3730 S NOLAND RD
-----------------------------------------------------
City | INDEPENDENCE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64055-3343
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-833-1232
-----------------------------------------------------
Fax | 816-326-0899
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF INSURANCE RELATIONS
-----------------------------------------------------
Name | MRS. JENNIFER CHRISTINE DARNELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 816-833-1232
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2005001567
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------