Provider Demographics
NPI:1164859203
Name:EUBANKS, DUSTIN CLINT (DC)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:CLINT
Last Name:EUBANKS
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 1:2192 HIGHWAY 172
Mailing Address - Street 2:
Mailing Address - City:WILMAR
Mailing Address - State:AR
Mailing Address - Zip Code:71675-7044
Mailing Address - Country:US
Mailing Address - Phone:870-723-3339
Mailing Address - Fax:
Practice Address - Street 1:604 A WEST BOLLING STREET
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655
Practice Address - Country:US
Practice Address - Phone:870-723-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16010111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor