Provider Demographics
NPI:1972794410
Name:JOHN BILLINGSLEY DC PC
Entity Type:Organization
Organization Name:JOHN BILLINGSLEY DC PC
Other - Org Name:LEWISBURG CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:BILLINGSLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:931-359-3468
Mailing Address - Street 1:1024 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-3520
Mailing Address - Country:US
Mailing Address - Phone:931-359-3468
Mailing Address - Fax:931-270-0952
Practice Address - Street 1:1024 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-3520
Practice Address - Country:US
Practice Address - Phone:931-359-3468
Practice Address - Fax:931-270-0952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000000298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0018631OtherBLUECROSS/BLUESHEILD
TNT74512Medicare UPIN
TN3672434Medicare PIN