Provider Demographics
NPI:1619962669
Name:HEDGEPATH, ROBERT L (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:HEDGEPATH
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 1:1029 C TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-1811
Mailing Address - Country:US
Mailing Address - Phone:540-586-5860
Mailing Address - Fax:540-586-5860
Practice Address - Street 1:1029 C TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-1811
Practice Address - Country:US
Practice Address - Phone:540-586-5860
Practice Address - Fax:540-586-5860
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000278111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA350046943Medicare PIN
T21589Medicare UPIN
VA350953306Medicare PIN