Provider Demographics
NPI:1740230002
Name:MUSE, JIM R (DC)
Entity Type:Individual
Prefix:DR
First Name:JIM
Middle Name:R
Last Name:MUSE
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 1:6825 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-1808
Mailing Address - Country:US
Mailing Address - Phone:405-634-1127
Mailing Address - Fax:405-634-1177
Practice Address - Street 1:6825 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1808
Practice Address - Country:US
Practice Address - Phone:405-634-1127
Practice Address - Fax:405-634-1177
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1616111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKT79986Medicare UPIN
OKQDBNFMedicare ID - Type Unspecified