Provider Demographics
NPI:1225025778
Name:CARSON, ERIC E (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:E
Last Name:CARSON
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 1:132 MEYERS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL
Mailing Address - State:AR
Mailing Address - Zip Code:71968-9304
Mailing Address - Country:US
Mailing Address - Phone:870-867-0172
Mailing Address - Fax:501-701-4050
Practice Address - Street 1:307 N GEORGE ST.
Practice Address - Street 2:
Practice Address - City:MOUNT IDA
Practice Address - State:AR
Practice Address - Zip Code:71957
Practice Address - Country:US
Practice Address - Phone:870-867-0172
Practice Address - Fax:501-701-4050
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR350044754OtherRR MEDICARE
AR59950G140Medicare PIN
ARU44266Medicare UPIN