Provider Demographics
NPI:1003981895
Name:ROBART JR., JAMES DALEY (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DALEY
Last Name:ROBART JR.
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 N MISSOURI ST
Mailing Address - Street 2:
Mailing Address - City:POTOSI
Mailing Address - State:MO
Mailing Address - Zip Code:63664-2101
Mailing Address - Country:US
Mailing Address - Phone:573-438-7200
Mailing Address - Fax:573-438-4507
Practice Address - Street 1:912 N MISSOURI ST
Practice Address - Street 2:
Practice Address - City:POTOSI
Practice Address - State:MO
Practice Address - Zip Code:63664
Practice Address - Country:US
Practice Address - Phone:573-438-7200
Practice Address - Fax:573-438-4507
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE#6565111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO431836615OtherAETNA, MERCY, FIRST HEALT
MO756252300Medicaid
MO431836615OtherHEALTHLINK AND PHCSNUMBER
MO110399OtherBCBS AND BLUECHOICE
MO350044981OtherRAILROAD MEDICARE NUMBER
MO431836615OtherHEALTHLINK AND PHCSNUMBER
MO110399OtherBCBS AND BLUECHOICE
MOU66778Medicare UPIN