Provider Demographics
NPI:1255347282
Name:SHOOK, ERIC SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:SCOTT
Last Name:SHOOK
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 1:1511 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-3757
Mailing Address - Country:US
Mailing Address - Phone:828-464-5655
Mailing Address - Fax:828-464-9969
Practice Address - Street 1:1511 NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-3757
Practice Address - Country:US
Practice Address - Phone:828-464-5655
Practice Address - Fax:828-464-9969
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1839111NS0005X
SC1534111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0878BOtherBLUE CROSS BLUE SHIELD
NC2447399AMedicare ID - Type Unspecified
NC0878BOtherBLUE CROSS BLUE SHIELD