Provider Demographics
NPI:1821285768
Name:STEVEN A SOPCAK DC
Entity Type:Organization
Organization Name:STEVEN A SOPCAK DC
Other - Org Name:FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANN
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-664-5681
Mailing Address - Street 1:156 W UNIVERSITY PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1617
Mailing Address - Country:US
Mailing Address - Phone:731-664-5681
Mailing Address - Fax:731-664-5393
Practice Address - Street 1:156 W UNIVERSITY PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1617
Practice Address - Country:US
Practice Address - Phone:731-664-5681
Practice Address - Fax:731-664-5393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3674660Medicare PIN
TNT74692Medicare UPIN