Provider Demographics
NPI:1689614497
Name:KIRCHHOFF, CRAIG EDWARD (DC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:EDWARD
Last Name:KIRCHHOFF
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 1:208 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:71852-2408
Mailing Address - Country:US
Mailing Address - Phone:870-845-0707
Mailing Address - Fax:870-845-0101
Practice Address - Street 1:208 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:AR
Practice Address - Zip Code:71852-2408
Practice Address - Country:US
Practice Address - Phone:870-845-0707
Practice Address - Fax:870-845-0101
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR672585OtherUNITED HEALTH CARE
AR5608512OtherFIRST HEALTH
AR5Y204OtherBCBS
AR155463718Medicaid
AR0779370OtherCIGNA
AR672585OtherUNITED HEALTH CARE