Provider Demographics
NPI:1083653893
Name:WILLIAM L INGLE DC
Entity Type:Organization
Organization Name:WILLIAM L INGLE DC
Other - Org Name:INGLE FAMILY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:INGLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:231-843-4088
Mailing Address - Street 1:321 N JEBAVY DR
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-1923
Mailing Address - Country:US
Mailing Address - Phone:231-843-4088
Mailing Address - Fax:231-845-2753
Practice Address - Street 1:321 N JEBAVY DRIVE
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431
Practice Address - Country:US
Practice Address - Phone:231-843-4088
Practice Address - Fax:231-845-2753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950E310490OtherBLUE CROSS BLUE SHIELD
138955OtherPREFERRED CHOICES
MIDG5641OtherPALMETTO
MI2717248Medicaid
MI2717248Medicaid