Provider Demographics
NPI:1861548414
Name:ESCHITI, JAMES EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:ESCHITI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 W GORE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-3629
Mailing Address - Country:US
Mailing Address - Phone:580-353-6776
Mailing Address - Fax:612-728-5859
Practice Address - Street 1:1201 W GORE BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3629
Practice Address - Country:US
Practice Address - Phone:580-353-6776
Practice Address - Fax:580-353-1214
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4155111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNC03479Medicare ID - Type Unspecified