Provider Demographics
NPI:1235314477
Name:PARKHURST, RAYMOND MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:MICHAEL
Last Name:PARKHURST
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 1:2 OFFICE PARK DR
Mailing Address - Street 2:STE A
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3859
Mailing Address - Country:US
Mailing Address - Phone:386-447-9930
Mailing Address - Fax:386-447-9931
Practice Address - Street 1:2 OFFICE PARK DR
Practice Address - Street 2:STE A
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3859
Practice Address - Country:US
Practice Address - Phone:386-447-9930
Practice Address - Fax:386-447-9931
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22755OtherBCBS OF FLORIDA
FL22755Medicare PIN