Provider Demographics
NPI:1184652836
Name:HESCHONG, ROGER S (DC)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:S
Last Name:HESCHONG
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 1:8703 HIGHWAY 19 E STE 2
Mailing Address - Street 2:
Mailing Address - City:ROAN MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37687-3375
Mailing Address - Country:US
Mailing Address - Phone:423-772-3691
Mailing Address - Fax:423-772-4713
Practice Address - Street 1:8703 HIGHWAY 19 E STE 2
Practice Address - Street 2:
Practice Address - City:ROAN MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37687-3375
Practice Address - Country:US
Practice Address - Phone:423-772-3691
Practice Address - Fax:423-772-4713
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTNDC275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4041930OtherBCBS TN PROVIDER NUMBER
TNP00014908OtherRAILROAD MEDICARE #
TN4041930OtherBCBS TN PROVIDER NUMBER
TN43-1968482OtherTAX ID NUMBER
TNT 74534Medicare UPIN