Provider Demographics
NPI:1124390752
Name:MCARTHUR CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:MCARTHUR CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:601-693-1100
Mailing Address - Street 1:4808 GREAT RIVER DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-2664
Mailing Address - Country:US
Mailing Address - Phone:601-693-1100
Mailing Address - Fax:601-483-7435
Practice Address - Street 1:4808 GREAT RIVER DR
Practice Address - Street 2:SUITE E
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-2664
Practice Address - Country:US
Practice Address - Phone:601-693-1100
Practice Address - Fax:601-483-7435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS418111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00115180Medicaid
MS350945471Medicare PIN
MST20819Medicare UPIN