Provider Demographics
NPI:1578504221
Name:IJIWOYE, JAMES ADEYEMO (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ADEYEMO
Last Name:IJIWOYE
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 1:325 N. ALMA SCHOOL ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4379
Mailing Address - Country:US
Mailing Address - Phone:480-912-3003
Mailing Address - Fax:480-264-3048
Practice Address - Street 1:325 N ALMA SCHOOL RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4379
Practice Address - Country:US
Practice Address - Phone:480-912-3003
Practice Address - Fax:480-264-3048
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8521111N00000X, 111N00000X
SC2435111N00000X
VA0104555691111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2435Medicaid
AZAZ0155870OtherBLUECROSSBLUESHEILD OF AZ
SC803370281Medicare UPIN