Provider Demographics
NPI:1235379561
Name:JAMESON, SAMUEL WARREN III (DC)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:WARREN
Last Name:JAMESON
Suffix:III
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 1:201 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWSON
Mailing Address - State:MO
Mailing Address - Zip Code:64062-7804
Mailing Address - Country:US
Mailing Address - Phone:816-580-7995
Mailing Address - Fax:
Practice Address - Street 1:201 E 6TH ST
Practice Address - Street 2:
Practice Address - City:LAWSON
Practice Address - State:MO
Practice Address - Zip Code:64062-7804
Practice Address - Country:US
Practice Address - Phone:816-580-7995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009002884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor