1598866857 NPI number — RUSSELL L JONES D C CHIROPRACTIC CORPORATION

Table of content: (NPI 1598866857)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598866857 NPI number — RUSSELL L JONES D C CHIROPRACTIC CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RUSSELL L JONES D C CHIROPRACTIC CORPORATION
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:
SMITH & JONES CHIROPRACTIC
Provider Other Organization Name Type Code:
3
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:
1598866857
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 WESTMORELAND OFFICE PARK
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUNBAR
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25064-2725
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-768-5068
Provider Business Mailing Address Fax Number:
304-768-6251

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 WESTMORELAND OFFICE PARK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNBAR
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25064-2725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-768-5068
Provider Business Practice Location Address Fax Number:
304-768-6251
Provider Enumeration Date:
09/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WITHROW
Authorized Official First Name:
TERESA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
304-768-5068

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  561 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1023091238 . This is a "R L JONES NPI" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 3810017569 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1073797379 . This is a "NPI" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 2203045000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0131699000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1073596284 . This is a "J S MORRIS NPI" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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