Provider Demographics
NPI:1316030489
Name:EWING, JAMES E (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:EWING
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:POBOX2177
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33427
Mailing Address - Country:US
Mailing Address - Phone:954-428-0225
Mailing Address - Fax:
Practice Address - Street 1:107 N POWERLINE RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-8037
Practice Address - Country:US
Practice Address - Phone:954-428-0225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7967111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53892OtherBLUE CROSS BLUE SHIELD
FL53892OtherBLUE CROSS BLUE SHIELD
FL53892Medicare ID - Type Unspecified