Provider Demographics
NPI:1558414896
Name:NAGLE CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:NAGLE CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-474-4470
Mailing Address - Street 1:808 E WAKEFIELD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-5147
Mailing Address - Country:US
Mailing Address - Phone:573-472-4470
Mailing Address - Fax:573-472-4139
Practice Address - Street 1:808 E WAKEFIELD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5147
Practice Address - Country:US
Practice Address - Phone:573-472-4470
Practice Address - Fax:573-472-4139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005752111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4401193OtherUNITED HEALTH CARE
MO189386OtherHEALTHLINK
350025205OtherRAILROAD MEDICARE PALMENT
MO106378OtherBCBS
MO4401193OtherUNITED HEALTH CARE
350025205OtherRAILROAD MEDICARE PALMENT