Provider Demographics
NPI:1225202815
Name:GUGEL CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:GUGEL CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CLAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CPC-H
Authorized Official - Phone:812-738-1112
Mailing Address - Street 1:1265 HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IN
Mailing Address - Zip Code:47112-2226
Mailing Address - Country:US
Mailing Address - Phone:812-738-1112
Mailing Address - Fax:812-738-1999
Practice Address - Street 1:1265 HILLVIEW DR
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-2226
Practice Address - Country:US
Practice Address - Phone:812-738-1112
Practice Address - Fax:812-738-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001058111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100228220AMedicaid
IN100228220AMedicaid
IN193360Medicare PIN