Provider Demographics
NPI:1922386507
Name:AUSTIN, MEGHANN DIANE (DC)
Entity type:Individual
Prefix:DR
First Name:MEGHANN
Middle Name:DIANE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MEGHANN
Other - Middle Name:DIANE
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:6103 S 37TH ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1630
Mailing Address - Country:US
Mailing Address - Phone:479-936-1550
Mailing Address - Fax:
Practice Address - Street 1:715 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-3407
Practice Address - Country:US
Practice Address - Phone:479-442-0352
Practice Address - Fax:479-442-4181
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15931111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor