Provider Demographics
NPI:1093806218
Name:WARREN, JAMES HASKELL (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HASKELL
Last Name:WARREN
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 1:800 W. BLUE STARR DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017
Mailing Address - Country:US
Mailing Address - Phone:918-342-9803
Mailing Address - Fax:918-343-1442
Practice Address - Street 1:800 W. BLUE STARR DRIVE
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017
Practice Address - Country:US
Practice Address - Phone:918-342-9803
Practice Address - Fax:918-343-1442
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3444111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU70425Medicare UPIN