Provider Demographics
NPI:1497814248
Name:LIMBAUGH, DAVID V (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:V
Last Name:LIMBAUGH
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 1:810 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-2187
Mailing Address - Country:US
Mailing Address - Phone:660-826-4830
Mailing Address - Fax:
Practice Address - Street 1:810 WINCHESTER DR
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-2187
Practice Address - Country:US
Practice Address - Phone:660-826-1918
Practice Address - Fax:660-826-6224
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE004618111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO09186013OtherBLUE CROSS BLUE SHIELD
MO09186013OtherBLUE CROSS BLUE SHIELD
MOT73752Medicare UPIN