Provider Demographics
NPI:1184700734
Name:WILLIAM C. ERIKSEN, PSC
Entity type:Organization
Organization Name:WILLIAM C. ERIKSEN, PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:ERIKSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-737-7597
Mailing Address - Street 1:415 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2769
Mailing Address - Country:US
Mailing Address - Phone:270-737-7597
Mailing Address - Fax:270-737-7756
Practice Address - Street 1:624 N DIXIE BLVD
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-1311
Practice Address - Country:US
Practice Address - Phone:270-737-7597
Practice Address - Fax:270-737-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8842Medicare PIN