Provider Demographics
NPI:1578767364
Name:OVERLAND, JAMES THOMAS SR (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:OVERLAND
Suffix:SR
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 1:2700 E LAKE MEAD BLVD STE 10
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-6512
Mailing Address - Country:US
Mailing Address - Phone:702-642-2440
Mailing Address - Fax:702-642-2448
Practice Address - Street 1:2700 E LAKE MEAD BLVD STE 10
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-6512
Practice Address - Country:US
Practice Address - Phone:702-399-6655
Practice Address - Fax:702-399-6671
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-527111N00000X, 111NI0013X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
Not Answered111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3602007Medicaid
NV3602007Medicaid
NVWCHNT02Medicare ID - Type Unspecified