MEDICARE: JAMES ROGER GOLDEN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	003672	MO

General Provider Information

NPI Number	:	1518054089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ROGER GOLDEN DC

Provider Business Mailing Address
First Line	:	1109 S BELT HWY
Second Line	:	SUITE 1
City	:	ST JOSEPH
State	:	MO
Zip	:	64507-2224
Country	:	US
Telephone Number	:	816-233-3940
Fax Number	:	816-233-3940

Provider Business Practice Location Address
First Line	:	1109 S BELT HWY
Second Line	:	SUITE 1
City	:	ST JOSEPH
State	:	MO
Zip	:	64507-2224
Country	:	US
Telephone Number	:	816-233-3940
Fax Number	:	816-233-3940

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	07/08/2007

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