Provider Demographics
NPI:1851687404
Name:CAUSEY, CHARLES FARMER (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FARMER
Last Name:CAUSEY
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 1:1023 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-1913
Mailing Address - Country:US
Mailing Address - Phone:478-742-4476
Mailing Address - Fax:478-742-4478
Practice Address - Street 1:1023 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-1913
Practice Address - Country:US
Practice Address - Phone:478-742-4476
Practice Address - Fax:478-742-4478
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor