Provider Demographics
NPI:1932399953
Name:HUMBER, JAMES K JR (D C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:K
Last Name:HUMBER
Suffix:JR
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 HERODIAN WAY SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-2906
Mailing Address - Country:US
Mailing Address - Phone:770-952-5353
Mailing Address - Fax:
Practice Address - Street 1:2424 HERODIAN WAY SE
Practice Address - Street 2:SUITE A
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-2906
Practice Address - Country:US
Practice Address - Phone:770-952-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAT97667Medicare UPIN