Provider Demographics
NPI:1609845981
Name:CARR, JOHN S (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:CARR
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 1:207 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MILLER
Mailing Address - State:SD
Mailing Address - Zip Code:57362-1426
Mailing Address - Country:US
Mailing Address - Phone:605-853-2230
Mailing Address - Fax:605-853-3111
Practice Address - Street 1:207 E 3RD ST
Practice Address - Street 2:
Practice Address - City:MILLER
Practice Address - State:SD
Practice Address - Zip Code:57362-1426
Practice Address - Country:US
Practice Address - Phone:605-853-2230
Practice Address - Fax:605-853-3111
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0006716OtherBSSD
SD4999851OtherBSSD
SD7602523Medicaid
SD7602524Medicaid
SD0082802OtherBSSD
SD7602084Medicaid
SD7602520Medicaid
SD4999861OtherBSSD
SD4999756OtherBSSD
SD7602522Medicaid
SD350034684Medicare PIN
SD350032643Medicare PIN
SD7602522Medicaid
SD350024002Medicare PIN
SD7602524Medicaid
SD7602084Medicaid
SDS82802Medicare PIN