Provider Demographics
NPI:1205939154
Name:FAULDS, JOHN BENJAMIN (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BENJAMIN
Last Name:FAULDS
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 1:180 OLD HIGHWAY 431
Mailing Address - Street 2:
Mailing Address - City:HAMPTON COVE
Mailing Address - State:AL
Mailing Address - Zip Code:35763-9271
Mailing Address - Country:US
Mailing Address - Phone:256-533-3443
Mailing Address - Fax:256-533-3637
Practice Address - Street 1:180 OLD HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:HAMPTON COVE
Practice Address - State:AL
Practice Address - Zip Code:35763-9271
Practice Address - Country:US
Practice Address - Phone:256-533-3443
Practice Address - Fax:256-533-3637
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2173111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor