Provider Demographics
NPI:1780780700
Name:ROY, JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:ROY
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:PO BOX 797
Mailing Address - Street 2:
Mailing Address - City:SAINT ROBERT
Mailing Address - State:MO
Mailing Address - Zip Code:65584-0797
Mailing Address - Country:US
Mailing Address - Phone:573-336-2230
Mailing Address - Fax:573-336-4285
Practice Address - Street 1:1106 OLD ROUTE 66
Practice Address - Street 2:SUITE 2D
Practice Address - City:SAINT ROBERT
Practice Address - State:MO
Practice Address - Zip Code:65584-4601
Practice Address - Country:US
Practice Address - Phone:573-336-2230
Practice Address - Fax:573-336-4285
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006439111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO44-03900OtherUNITED HEALTHCARE
MO112851OtherBLUE CROSS/BLUE SHIELD
MO112851OtherBLUE CROSS/BLUE SHIELD