Provider Demographics
NPI:1669419537
Name:JAMES V. MCCOLLUM, D.C. P.C.
Entity type:Organization
Organization Name:JAMES V. MCCOLLUM, D.C. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:V
Authorized Official - Last Name:MCCOLLUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-338-8885
Mailing Address - Street 1:325 N PERKINS AVE
Mailing Address - Street 2:
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-5415
Mailing Address - Country:US
Mailing Address - Phone:580-338-8885
Mailing Address - Fax:580-338-8561
Practice Address - Street 1:325 N PERKINS AVE
Practice Address - Street 2:
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942-5415
Practice Address - Country:US
Practice Address - Phone:580-338-8885
Practice Address - Fax:580-338-8561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty