Provider Demographics
NPI:1184955262
Name:HAUGHTON, JEREMY D (DC)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:D
Last Name:HAUGHTON
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 1:4711 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-1626
Mailing Address - Country:US
Mailing Address - Phone:913-432-5678
Mailing Address - Fax:
Practice Address - Street 1:4711 MISSION RD
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-1626
Practice Address - Country:US
Practice Address - Phone:913-432-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05293111N00000X
MO2009032229111N00000X
GACHIR009134111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA1961001Medicare PIN