Provider Demographics
NPI:1831284884
Name:MAUPIN, JAMES LAWRENCE (D C)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LAWRENCE
Last Name:MAUPIN
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 MCDOWELL BLVD. SUITE 200
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-2651
Mailing Address - Country:US
Mailing Address - Phone:502-331-9676
Mailing Address - Fax:502-331-9683
Practice Address - Street 1:703 MCDOWELL BLVD. SUITE 200
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-2651
Practice Address - Country:US
Practice Address - Phone:502-331-9676
Practice Address - Fax:502-331-9683
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000041697OtherANTHME BCBS
KY2443880000Medicaid
KY2507847OtherAETNA INSURANCE
KY6076301Medicare ID - Type Unspecified
KY2443880000Medicaid