Provider Demographics
NPI:1225107675
Name:HUMISTON, RICHARD SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SCOTT
Last Name:HUMISTON
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 1:1334 ASHEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3414
Mailing Address - Country:US
Mailing Address - Phone:828-694-0020
Mailing Address - Fax:828-694-0022
Practice Address - Street 1:1334 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3414
Practice Address - Country:US
Practice Address - Phone:828-694-0020
Practice Address - Fax:828-694-0022
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5850111N00000X
SC2151111N00000X
NC2558111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0841YOtherBCBS
NC890841YMedicaid
NC2453986Medicare ID - Type Unspecified
NC890841YMedicaid