1033553680 NPI number — WARD CHIROPRACTIC

Table of content: JAMES ALLEN MCCAULLEY JR. HHA (NPI 1235734435)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033553680 NPI number — WARD CHIROPRACTIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WARD CHIROPRACTIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033553680
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4211 LAKE STREET
Provider Second Line Business Mailing Address:
SUITE 20
Provider Business Mailing Address City Name:
LAKE CHARLES
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-990-5497
Provider Business Mailing Address Fax Number:
337-990-5570

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4211 LAKE STREET
Provider Second Line Business Practice Location Address:
SUITE 20
Provider Business Practice Location Address City Name:
LAKE CHARLES
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-990-5497
Provider Business Practice Location Address Fax Number:
337-990-5570
Provider Enumeration Date:
04/25/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BRAY WARD
Authorized Official First Name:
PATTE
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OWNER/CHIROPRACTOR
Authorized Official Telephone Number:
337-990-5497

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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