1366477994 NPI number — DAN A MEFFORD D.C.

Table of content: DAN A MEFFORD D.C. (NPI 1366477994)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366477994 NPI number — DAN A MEFFORD D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEFFORD
Provider First Name:
DAN
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C.
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:
1366477994
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
813 W WASHINGTON ST
Provider Second Line Business Mailing Address:
P.O. BOX 7
Provider Business Mailing Address City Name:
PITTSFIELD
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62363-1353
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
217-285-5641
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
813 W WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSFIELD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62363-1353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-285-5641
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2006

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:  38-003654 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 022174 . This is a "HEALTH ALLICANCE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 371078387 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 651978 . This is a "ACN" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 371078387 . This is a "MULTI PLAN" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 0998215 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 371078387 . This is a "INTEGRATED HEALTH PLAN" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 731194 . This is a "HEALTHLINK" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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