Provider Demographics
NPI:1104012095
Name:MICHAEL R COMPTON D.C.,P.C.
Entity Type:Organization
Organization Name:MICHAEL R COMPTON D.C.,P.C.
Other - Org Name:LINCOLN COUNTY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:931-433-0067
Mailing Address - Street 1:2686 HUNTSVILLE HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37334-7647
Mailing Address - Country:US
Mailing Address - Phone:931-433-0067
Mailing Address - Fax:931-433-9005
Practice Address - Street 1:2686 HUNTSVILLE HWY
Practice Address - Street 2:SUITE C
Practice Address - City:FAYETTEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37334-7647
Practice Address - Country:US
Practice Address - Phone:931-433-0067
Practice Address - Fax:931-433-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4169119OtherBC/BS
TN4169119OtherBC/BS