Provider Demographics
NPI:1417964388
Name:MEGGISON, JAY DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:DOUGLAS
Last Name:MEGGISON
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 1:704 CEDAR POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:CEDAR POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28584-8012
Mailing Address - Country:US
Mailing Address - Phone:252-393-5090
Mailing Address - Fax:252-393-3567
Practice Address - Street 1:704 CEDAR POINT BLVD
Practice Address - Street 2:
Practice Address - City:CEDAR POINT
Practice Address - State:NC
Practice Address - Zip Code:28584-8012
Practice Address - Country:US
Practice Address - Phone:252-393-5090
Practice Address - Fax:252-393-3567
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1417964388OtherBCBS
NC1417964388Medicaid
NC1417964388Medicare PIN
NC1417964388Medicare UPIN