Provider Demographics
NPI:1255481941
Name:ESS, PATRICK RUSSELL (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:RUSSELL
Last Name:ESS
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 1:9753 STONYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:STANFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:28163-8678
Mailing Address - Country:US
Mailing Address - Phone:704-989-4600
Mailing Address - Fax:
Practice Address - Street 1:9401 STATESVILLE RD
Practice Address - Street 2:H
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-7600
Practice Address - Country:US
Practice Address - Phone:704-989-4600
Practice Address - Fax:704-597-7491
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085WAOtherBCBS PROVIDER ID
NC085WAOtherBCBS PROVIDER ID
NCC715Medicare PIN
NC2457987AMedicare PIN
NCU93928OtherBCBS