Provider Demographics
NPI:1215949094
Name:ROUSE, DAVID KING (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KING
Last Name:ROUSE
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 1:2711 UNIVERSITY BLVD N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-3235
Mailing Address - Country:US
Mailing Address - Phone:904-743-6700
Mailing Address - Fax:904-745-9101
Practice Address - Street 1:2711 UNIVERSITY BLVD N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-3235
Practice Address - Country:US
Practice Address - Phone:904-743-6700
Practice Address - Fax:904-745-9101
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2499111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT56370Medicare UPIN