Provider Demographics
NPI:1376525402
Name:MCCAUGHAN, RICHARD DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DEAN
Last Name:MCCAUGHAN
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 1:3106 DEVINE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-1846
Mailing Address - Country:US
Mailing Address - Phone:803-252-2255
Mailing Address - Fax:
Practice Address - Street 1:3106 DEVINE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-1846
Practice Address - Country:US
Practice Address - Phone:803-252-2255
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2879111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2879OtherDC LICENSE