1952441925 NPI number — N. FRANK MCCRELESS PC

Table of content: (NPI 1952441925)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952441925 NPI number — N. FRANK MCCRELESS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
N. FRANK MCCRELESS PC
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:
WINSTON COUNTY 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:
1952441925
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 514
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOUBLE SPRINGS
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35553-0514
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-489-3393
Provider Business Mailing Address Fax Number:
205-489-5259

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25179 HIGHWAY 195
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOUBLE SPRINGS
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-489-3393
Provider Business Practice Location Address Fax Number:
205-489-5259
Provider Enumeration Date:
02/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCCRELESS
Authorized Official First Name:
NICKEY
Authorized Official Middle Name:
FRANK
Authorized Official Title or Position:
OWNER CHIROPRACTOR
Authorized Official Telephone Number:
205-489-3393

Provider Taxonomy Codes

  • Taxonomy code: 111NR0400X , with the licence number:  1853 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 051077806 . This is a "BLUE SHIELD PROVIDER NUMB" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com