Provider Demographics
NPI:1578751442
Name:JASON W SLINKER DC PSC
Entity Type:Organization
Organization Name:JASON W SLINKER DC PSC
Other - Org Name:GREEN RIVER CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:W
Authorized Official - Last Name:SLINKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-932-2030
Mailing Address - Street 1:603B COLUMBIA HWY
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:42743-1115
Mailing Address - Country:US
Mailing Address - Phone:270-932-2030
Mailing Address - Fax:270-932-2031
Practice Address - Street 1:603B COLUMBIA HWY
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KY
Practice Address - Zip Code:42743-1115
Practice Address - Country:US
Practice Address - Phone:270-932-2030
Practice Address - Fax:270-932-2031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4488111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000292100OtherANTHEM
KY85002376Medicaid
KYU73808Medicare UPIN
KY85002376Medicaid