Provider Demographics
NPI:1558423053
Name:MYERS, JAMES DANIEL (DC, DPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DANIEL
Last Name:MYERS
Suffix:
Gender:M
Credentials:DC, DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 E 97TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-5009
Mailing Address - Country:US
Mailing Address - Phone:918-299-6728
Mailing Address - Fax:918-299-7185
Practice Address - Street 1:6019 S 66TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-9209
Practice Address - Country:US
Practice Address - Phone:918-493-2825
Practice Address - Fax:918-299-7185
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2431111N00000X
OK9005183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered183500000XPharmacy Service ProvidersPharmacist