Provider Demographics
NPI:1225015688
Name:AGEE, DWIGHT LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:LEE
Last Name:AGEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2811 LURLEEN B WALLACE BLVD
Mailing Address - Street 2:STE 12
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476
Mailing Address - Country:US
Mailing Address - Phone:205-339-3333
Mailing Address - Fax:205-339-2023
Practice Address - Street 1:2811 LURLEEN B WALLACE BLVD
Practice Address - Street 2:STE 12
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476
Practice Address - Country:US
Practice Address - Phone:205-339-3333
Practice Address - Fax:205-339-2023
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1214111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL9532771OtherCIGNA
AL9532771OtherCIGNA