Provider Demographics
NPI:1205876364
Name:SUBA, JAMES DAVID (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:SUBA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 12190
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85732-2190
Mailing Address - Country:US
Mailing Address - Phone:520-609-8900
Mailing Address - Fax:520-293-1788
Practice Address - Street 1:698 E WETMORE RD
Practice Address - Street 2:STE 320
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1751
Practice Address - Country:US
Practice Address - Phone:520-408-2225
Practice Address - Fax:520-293-1788
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ7338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZV01155Medicare UPIN