Provider Demographics
NPI:1083798094
Name:CULBERSON, JAMES DONALD (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DONALD
Last Name:CULBERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 MIDWAY ST NW
Mailing Address - Street 2:
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640-4515
Mailing Address - Country:US
Mailing Address - Phone:256-773-8896
Mailing Address - Fax:256-773-8891
Practice Address - Street 1:807 MIDWAY ST NW
Practice Address - Street 2:
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640-4515
Practice Address - Country:US
Practice Address - Phone:256-773-8896
Practice Address - Fax:256-773-8891
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1260111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU48584Medicare UPIN
AL000074516Medicare ID - Type Unspecified