Provider Demographics
NPI:1932136496
Name:HALEY, JAMES EDWARD (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:HALEY
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 1:321 WHITFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-1529
Mailing Address - Country:US
Mailing Address - Phone:941-376-2191
Mailing Address - Fax:941-927-8731
Practice Address - Street 1:3687 WEBBER ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-4412
Practice Address - Country:US
Practice Address - Phone:941-922-9312
Practice Address - Fax:941-927-8731
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7486111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74824OtherBCBS
FL74824OtherBCBS
FLU49552Medicare UPIN
FL55644Medicare ID - Type Unspecified