Provider Demographics
NPI:1386662468
Name:SHEETS, PAUL MILTON (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MILTON
Last Name:SHEETS
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 1:962 BROADWAY PLAZA
Mailing Address - Street 2:
Mailing Address - City:PAINTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41240-1346
Mailing Address - Country:US
Mailing Address - Phone:606-789-4631
Mailing Address - Fax:606-789-4641
Practice Address - Street 1:962 BROADWAY PLAZA
Practice Address - Street 2:
Practice Address - City:PAINTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41240-1346
Practice Address - Country:US
Practice Address - Phone:606-789-4631
Practice Address - Fax:606-789-4641
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85000172Medicaid
KY85000172Medicaid
KYU49703Medicare UPIN