Provider Demographics
NPI:1639231160
Name:EMERY, EARL PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:EARL
Middle Name:PAUL
Last Name:EMERY
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:PO BOX 756
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-0756
Mailing Address - Country:US
Mailing Address - Phone:207-454-7311
Mailing Address - Fax:207-454-7311
Practice Address - Street 1:461 U.S. ROUTE 1
Practice Address - Street 2:
Practice Address - City:BARING
Practice Address - State:ME
Practice Address - Zip Code:04694
Practice Address - Country:US
Practice Address - Phone:207-454-7311
Practice Address - Fax:207-454-7311
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEU44246Medicare UPIN
MM5036Medicare ID - Type Unspecified