Provider Demographics
NPI:1124011630
Name:ARMSTRONG, JONATHAN K (DC)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:K
Last Name:ARMSTRONG
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 1:851 S COLORADO
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738
Mailing Address - Country:US
Mailing Address - Phone:417-732-4000
Mailing Address - Fax:417-732-9702
Practice Address - Street 1:851 S COLORADO
Practice Address - Street 2:
Practice Address - City:REPUBLIC
Practice Address - State:MO
Practice Address - Zip Code:65738
Practice Address - Country:US
Practice Address - Phone:417-732-4000
Practice Address - Fax:417-732-9702
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4606111N00000X
MO2010040956111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000298359OtherBCBS
KY85003119Medicaid
KY50001171OtherPASSPORT
KY85003119Medicaid
KY50001171OtherPASSPORT
KYU82179Medicare UPIN