Endre Dejuan Matthews in Jackson - Chiropractor
Endre Dejuan Matthews - NPI 1457480469
Endre Dejuan Matthews is a Chiropractor in Jackson, Mississippi. Endre Dejuan Matthews practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Endre Dejuan Matthews is 1457480469. The last update date is 2007-07-09.
Endre Dejuan Matthews's current location address is 108 E Northside Dr, Jackson, Mississippi. You can contact this provider via phone number 6013669005 and fax number 6013669005. The mailing address for Endre Dejuan Matthews is 108 E Northside Dr, Jackson, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Endre Dejuan Matthews |
|---|---|
| Address | 108 E Northside Dr, Jackson, Mississippi |
| Phone Number | 6013669005 |
| Fax Number | 6013669005 |
| Sole Proprietor | Y |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1457480469 |
|---|---|
| Provider Enumeration Date | 2007-03-05 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 108 E Northside Dr |
|---|---|
| City | Jackson |
| State | Mississippi (MS) |
| Post Code | 392065417 |
| Phone Number | 6013669005 |
| Fax Number | 6013669005 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 1015 |
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Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 125438 | MS | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Endre Dejuan Matthews by the Centers for Medicare & Medicaid Services?
The Endre Dejuan Matthews has been issued the NPI (National Provider Identifier) 1457480469, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Endre Dejuan Matthews's physical address?
The Endre Dejuan Matthews is physically located at 108 E Northside Dr, in the city of Jackson, MS, with the postal code 392065417.
What is the Endre Dejuan Matthews's specialty and taxonomy code?
The Endre Dejuan Matthews's specialty is Chiropractor, and the corresponding taxonomy code is 111N00000X.
On what date was the 1457480469 assigned to Endre Dejuan Matthews?
The Endre Dejuan Matthews was issued its 1457480469 on 2007-03-05, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Endre Dejuan Matthews, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Endre Dejuan Matthews, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-09.