Provider Demographics
NPI:1871502922
Name:DUPUIS, PIERRE (DC)
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:
Last Name:DUPUIS
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 1:416 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-3215
Mailing Address - Country:US
Mailing Address - Phone:573-636-6341
Mailing Address - Fax:
Practice Address - Street 1:416 E HIGH ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-3215
Practice Address - Country:US
Practice Address - Phone:573-636-6341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004127111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO5894Medicare UPIN
MOT-43288Medicare UPIN
MO0030689Medicare ID - Type Unspecified