Provider Demographics
NPI:1962460592
Name:READE, JAMES DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DOUGLAS
Last Name:READE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:DOUGLAS
Other - Last Name:READE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC PLLC
Mailing Address - Street 1:2430 WEST RAY RD
Mailing Address - Street 2:STE 1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224
Mailing Address - Country:US
Mailing Address - Phone:480-732-0911
Mailing Address - Fax:480-812-0533
Practice Address - Street 1:2430 WEST RAY RD
Practice Address - Street 2:STE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-732-0911
Practice Address - Fax:480-812-0533
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3785111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0000BGLZMMedicare ID - Type UnspecifiedMEDICARE ID
AZT42063Medicare UPIN