Provider Demographics
NPI:1275512014
Name:SOMERS, ERIC DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DAVID
Last Name:SOMERS
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 1:11807 NORTHFALL LN
Mailing Address - Street 2:STE 901
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7972
Mailing Address - Country:US
Mailing Address - Phone:678-240-0049
Mailing Address - Fax:678-240-0304
Practice Address - Street 1:11807 NORTHFALL LN
Practice Address - Street 2:SUITE 901
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7977
Practice Address - Country:US
Practice Address - Phone:678-240-0049
Practice Address - Fax:678-240-0304
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009338111N00000X
PAAJ009151174400000X
GACHIROO8283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2412159000OtherKEYSTONE
PA1746831OtherPERSONAL CHOICE
GA723626OtherUNITED HEALTHCARE
PAS01746831OtherHIGHMARK
PA1746831OtherPERSONAL CHOICE
GA511I350075Medicare PIN
PA2412159000OtherKEYSTONE