Provider Demographics
NPI:1053411090
Name:KING, JAMES IRA (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:IRA
Last Name:KING
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 1:865 S 500 W
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-3201
Mailing Address - Country:US
Mailing Address - Phone:801-465-4999
Mailing Address - Fax:801-465-0981
Practice Address - Street 1:865 S 500 W
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-3201
Practice Address - Country:US
Practice Address - Phone:801-465-4999
Practice Address - Fax:801-465-7980
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2774304-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor