Provider Demographics
NPI:1770561557
Name:MARKER, JAMES BENSON (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BENSON
Last Name:MARKER
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 1:2212 CLEVELAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:FT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901
Mailing Address - Country:US
Mailing Address - Phone:239-334-6418
Mailing Address - Fax:239-334-7081
Practice Address - Street 1:2212 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901
Practice Address - Country:US
Practice Address - Phone:239-334-6418
Practice Address - Fax:239-334-7081
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8070111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
53916OtherBCBS
P00004532OtherMC RAILRD
FL381335500Medicaid
109353OtherAMERIGROUP
280184OtherAVMED
U82585Medicare UPIN
53916OtherBCBS