Provider Demographics
NPI:1306817531
Name:COMBS, JOHN EDWARD (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:EDWARD
Last Name:COMBS
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 1:954 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-3747
Mailing Address - Country:US
Mailing Address - Phone:317-467-4444
Mailing Address - Fax:317-467-4020
Practice Address - Street 1:892 S STATE ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-2536
Practice Address - Country:US
Practice Address - Phone:317-467-4444
Practice Address - Fax:317-467-4020
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002087A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000306903OtherANTHEM BCBS
IN200450310AMedicaid