1932386240 NPI number — DOUDNA CHIROPRACTIC, LLC

Table of content: (NPI 1932386240)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932386240 NPI number — DOUDNA CHIROPRACTIC, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOUDNA CHIROPRACTIC, LLC
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:
1932386240
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 114
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CALDWELL
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43724-0114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-732-4242
Provider Business Mailing Address Fax Number:
740-732-9980

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 NORTH ST
Provider Second Line Business Practice Location Address:
SUITE #1
Provider Business Practice Location Address City Name:
CALDWELL
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43724-1217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-732-4242
Provider Business Practice Location Address Fax Number:
740-732-9980
Provider Enumeration Date:
01/29/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DOUDNA
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
Authorized Official Title or Position:
SOLE MBR.
Authorized Official Telephone Number:
740-732-4242

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1398 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0741219 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1398 . This is a "THE HEALTH PLAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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