Provider Demographics
NPI:1508815226
Name:POYNTER, NICHOLAS DWIGHT (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:DWIGHT
Last Name:POYNTER
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 1:200 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:TOMPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42167-1611
Mailing Address - Country:US
Mailing Address - Phone:270-487-6254
Mailing Address - Fax:270-487-1462
Practice Address - Street 1:200 E 4TH ST
Practice Address - Street 2:
Practice Address - City:TOMPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42167-1611
Practice Address - Country:US
Practice Address - Phone:270-487-6254
Practice Address - Fax:270-487-1462
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4981111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY204607917OtherHUMANA
KY1578508719OtherANTHEM BLUE CROSS AND BLUE SHIELD
KY85003911Medicaid
KY1578508719OtherANTHEM BLUE CROSS AND BLUE SHIELD