Provider Demographics
NPI:1639262488
Name:EARNST CLINIC INC
Entity Type:Organization
Organization Name:EARNST CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER.DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:EARNST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:336-434-4600
Mailing Address - Street 1:231 BAKER ROAD
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27263
Mailing Address - Country:US
Mailing Address - Phone:336-434-4600
Mailing Address - Fax:336-434-4610
Practice Address - Street 1:231 BAKER ROAD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27263
Practice Address - Country:US
Practice Address - Phone:336-434-4600
Practice Address - Fax:336-434-4610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890835JMedicaid
NC350052306OtherRAILROAD MEDICARE
NCU74855Medicare UPIN
NC2453064AMedicare ID - Type UnspecifiedMEDICARE NUMBER