Provider Demographics
NPI:1841207883
Name:OROURKE, JAMES WILLIAM JR (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:OROURKE
Suffix:JR
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 1:21505 STATE HIGHWAY 190
Mailing Address - Street 2:
Mailing Address - City:JAMESPORT
Mailing Address - State:MO
Mailing Address - Zip Code:64648-7297
Mailing Address - Country:US
Mailing Address - Phone:660-684-6500
Mailing Address - Fax:660-684-6550
Practice Address - Street 1:21505 STATE HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:JAMESPORT
Practice Address - State:MO
Practice Address - Zip Code:64648-7297
Practice Address - Country:US
Practice Address - Phone:660-684-6500
Practice Address - Fax:660-684-6550
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006667111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOT62B531Medicare ID - Type Unspecified