Provider Demographics
NPI:1669680617
Name:DYER, WILLIAM R (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:DYER
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 1:133 PEACHTREE ST
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-2909
Mailing Address - Country:US
Mailing Address - Phone:828-837-2924
Mailing Address - Fax:828-837-2924
Practice Address - Street 1:133 PEACHTREE ST
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-2909
Practice Address - Country:US
Practice Address - Phone:828-837-2924
Practice Address - Fax:828-837-2924
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC920111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8908371Medicaid
NC244206Medicare ID - Type Unspecified