MEDICARE: DR. JAMES D RAKER 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	1141	AR
2	111N00000X	Chiropractor	5184	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932103892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES D RAKER DC

Provider Business Mailing Address
First Line	:	1414 ARKANSAS BLVD
Second Line	:
City	:	TEXARKANA
State	:	AR
Zip	:	71854-1604
Country	:	US
Telephone Number	:	870-773-7246
Fax Number	:	870-772-2568

Provider Business Practice Location Address
First Line	:	1414 ARKANSAS BLVD
Second Line	:
City	:	TEXARKANA
State	:	AR
Zip	:	71854-1604
Country	:	US
Telephone Number	:	870-773-7246
Fax Number	:	870-772-2568

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	10/01/2024

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