Provider Demographics
NPI:1124012570
Name:POPLAWSKI, RICHARD JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOHN
Last Name:POPLAWSKI
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 1:4 BENEDICT ST
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-2102
Mailing Address - Country:US
Mailing Address - Phone:570-655-3705
Mailing Address - Fax:570-602-8370
Practice Address - Street 1:4 BENEDICT ST
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-2102
Practice Address - Country:US
Practice Address - Phone:570-655-3705
Practice Address - Fax:570-602-8370
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-004241-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012008200001Medicaid
PA594985OtherBC/BS
PA0012008200001Medicaid
PA594985OtherBC/BS