Provider Demographics
NPI:1760444582
Name:MEAD CHIROPRACTIC & ACUPUNCTURE PC
Entity Type:Organization
Organization Name:MEAD CHIROPRACTIC & ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:MEAD
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:910-343-9779
Mailing Address - Street 1:1201B S 16TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6419
Mailing Address - Country:US
Mailing Address - Phone:910-343-9779
Mailing Address - Fax:910-343-9669
Practice Address - Street 1:1201B S 16TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6419
Practice Address - Country:US
Practice Address - Phone:910-343-9779
Practice Address - Fax:910-343-9669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08689OtherBCBS OF NC
NC8908689Medicaid
NCT97105Medicare UPIN
NC8908689Medicaid