1134228976 NPI number — DR. RICK L. TOWNSEND DC, NMD

Table of content: DR. RICK L. TOWNSEND DC, NMD (NPI 1134228976)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134228976 NPI number — DR. RICK L. TOWNSEND DC, NMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOWNSEND
Provider First Name:
RICK
Provider Middle Name:
L.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC, NMD
Provider Gender Code:
M

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:
1134228976
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 459
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAYNESVILLE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65583-0459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-336-4221
Provider Business Mailing Address Fax Number:
573-996-4714

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
394 OLD ROUTE 66
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SAINT ROBERT
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65584-3727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-336-4221
Provider Business Practice Location Address Fax Number:
573-996-4714
Provider Enumeration Date:
09/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  006067 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 128392 . This is a "BC/BS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 666734 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".