Provider Demographics
NPI:1356638779
Name:DOOLIN, JASON S (DC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:S
Last Name:DOOLIN
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 1:4991 N BUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-2339
Mailing Address - Country:US
Mailing Address - Phone:505-325-2010
Mailing Address - Fax:866-282-1239
Practice Address - Street 1:4991 N BUTLER AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-2339
Practice Address - Country:US
Practice Address - Phone:505-325-2010
Practice Address - Fax:866-282-1239
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor