Provider Demographics
NPI:1982641205
Name:ELIOPULOS, THOMAS E (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:ELIOPULOS
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 1:7862 KINGLAND DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2573
Mailing Address - Country:US
Mailing Address - Phone:513-755-1341
Mailing Address - Fax:513-755-5342
Practice Address - Street 1:7862 KINGLAND DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2573
Practice Address - Country:US
Practice Address - Phone:513-755-1341
Practice Address - Fax:513-755-5342
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH086773Medicaid
OHU55664Medicare UPIN
OH086773Medicaid