Provider Demographics
NPI:1871664235
Name:CARSON, JEFFREY JAMES (DC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:JAMES
Last Name:CARSON
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 1:3907 CENTRAL AVE
Mailing Address - Street 2:STE. #6
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-7210
Mailing Address - Country:US
Mailing Address - Phone:501-525-7171
Mailing Address - Fax:501-525-7171
Practice Address - Street 1:3907 CENTRAL AVE
Practice Address - Street 2:STE. #6
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-7210
Practice Address - Country:US
Practice Address - Phone:501-525-7171
Practice Address - Fax:501-525-7171
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2012-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59081Medicare ID - Type Unspecified