Provider Demographics
NPI:1801838743
Name:TEIFKE, MICHAEL EDWARD (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EDWARD
Last Name:TEIFKE
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 1:401 W EADS PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-1374
Mailing Address - Country:US
Mailing Address - Phone:812-539-2900
Mailing Address - Fax:812-539-2999
Practice Address - Street 1:401 W EADS PKWY STE 320
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1374
Practice Address - Country:US
Practice Address - Phone:812-539-2900
Practice Address - Fax:812-539-2999
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1937111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0966647Medicaid
OHTE0746132Medicare PIN
OH0966647Medicaid