Provider Demographics
NPI:1770633778
Name:HITSON FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HITSON FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:HITSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-744-0423
Mailing Address - Street 1:PO BOX 797
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650
Mailing Address - Country:US
Mailing Address - Phone:724-744-0423
Mailing Address - Fax:724-744-0902
Practice Address - Street 1:2030 PENNY LANE
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644
Practice Address - Country:US
Practice Address - Phone:724-744-0423
Practice Address - Fax:724-744-0902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007937L111N00000X
PADC007408L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
786646OtherBCBS GROUP DR JIM HITSON
995730OtherBCBS IND. DR JIM HITSON
U74145Medicare UPIN
PA024704Medicare ID - Type Unspecified
PA075890Medicare ID - Type Unspecified
995730OtherBCBS IND. DR JIM HITSON