Provider Demographics
NPI:1083917447
Name:DAVID N HESKETT DC LLC
Entity Type:Organization
Organization Name:DAVID N HESKETT DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:KAREN
Authorized Official - Last Name:HESKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-657-1302
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:HOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:67740-0014
Mailing Address - Country:US
Mailing Address - Phone:785-675-3143
Mailing Address - Fax:785-675-2033
Practice Address - Street 1:1132 OAK AVE
Practice Address - Street 2:
Practice Address - City:HOXIE
Practice Address - State:KS
Practice Address - Zip Code:67740
Practice Address - Country:US
Practice Address - Phone:785-675-3143
Practice Address - Fax:785-675-2033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0103810111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA2031Medicare UPIN