Provider Demographics
NPI:1417962721
Name:HUNEYCUTT, MATTHEW C (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:C
Last Name:HUNEYCUTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:MATT
Other - Middle Name:
Other - Last Name:HUNEYCUTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:25255 HIGHWAY 5
Mailing Address - Street 2:STE K
Mailing Address - City:LONSDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72087-9102
Mailing Address - Country:US
Mailing Address - Phone:501-568-6612
Mailing Address - Fax:501-568-7454
Practice Address - Street 1:7117 GEYER SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-3644
Practice Address - Country:US
Practice Address - Phone:501-568-6612
Practice Address - Fax:501-568-7454
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1621111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X997OtherBLUE CROSS BLUE SHIELD
AR7470597OtherAETNA
ARP00144384OtherRAILROAD MEDICARE
AR2222627OtherFIRST HEALTH
ARV00894Medicare UPIN
AR5X997OtherBLUE CROSS BLUE SHIELD