Provider Demographics
NPI:1154510477
Name:HOWARD FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:HOWARD FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DUDLEY
Authorized Official - Middle Name:MOYE
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-283-4300
Mailing Address - Street 1:2509 PLANT AVE STE C
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-6086
Mailing Address - Country:US
Mailing Address - Phone:912-283-4300
Mailing Address - Fax:912-283-3938
Practice Address - Street 1:2509 PLANT AVE STE C
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-6086
Practice Address - Country:US
Practice Address - Phone:912-283-4300
Practice Address - Fax:912-283-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007103111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4344OtherMEDICARE GROUP NUMBER
GA35ZCGRCMedicare UPIN