Provider Demographics
NPI:1609919034
Name:SACCOMAN, JOSEPH WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:SACCOMAN
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 1:3790 HIGHWAY 395 S., STE 303
Mailing Address - Street 2:JOE SACCOMAN, D.C.,
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89705-5808
Mailing Address - Country:US
Mailing Address - Phone:775-267-3844
Mailing Address - Fax:
Practice Address - Street 1:3790 HWY 395 S. STE 303
Practice Address - Street 2:JOE SACCOMAN, D.C.,
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89705-5808
Practice Address - Country:US
Practice Address - Phone:775-267-3844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV102026Medicare PIN