Provider Demographics
NPI:1821276304
Name:TOUGAS CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:TOUGAS CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:MICHEAL
Authorized Official - Last Name:TOUGAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:479-696-8697
Mailing Address - Street 1:PO BOX 5437
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72913-5437
Mailing Address - Country:US
Mailing Address - Phone:479-696-8697
Mailing Address - Fax:918-398-0637
Practice Address - Street 1:205 E RAY FINE BLVD
Practice Address - Street 2:SUITE #6
Practice Address - City:ROLAND
Practice Address - State:OK
Practice Address - Zip Code:74954-5181
Practice Address - Country:US
Practice Address - Phone:479-696-8697
Practice Address - Fax:918-398-0637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKB5122Medicare PIN