Provider Demographics
NPI:1376627059
Name:JOY, JASON ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:ALAN
Last Name:JOY
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 1:900 W FRONTVIEW ST
Mailing Address - Street 2:ST 101
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-2233
Mailing Address - Country:US
Mailing Address - Phone:620-225-8677
Mailing Address - Fax:620-225-8679
Practice Address - Street 1:900 W FRONTVIEW ST STE 101
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-2233
Practice Address - Country:US
Practice Address - Phone:620-225-8677
Practice Address - Fax:620-225-8679
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04895111NS0005X
KS0104895111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062104Medicare ID - Type Unspecified
U99895Medicare UPIN