Provider Demographics
NPI:1811973340
Name:OAKES, DARRELL E (DC)
Entity type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:E
Last Name:OAKES
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 1:3183 N COLE RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-5921
Mailing Address - Country:US
Mailing Address - Phone:208-322-4555
Mailing Address - Fax:208-322-4556
Practice Address - Street 1:3183 N COLE RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-5921
Practice Address - Country:US
Practice Address - Phone:208-322-4555
Practice Address - Fax:208-322-4556
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-476111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1671762Medicare ID - Type Unspecified
IDT44487Medicare UPIN