Provider Demographics
NPI:1265590830
Name:CARMACK, JOSHUA CHARLES (DC)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:CHARLES
Last Name:CARMACK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:222 VILLAGE SQ
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37146-7176
Mailing Address - Country:US
Mailing Address - Phone:615-746-8700
Mailing Address - Fax:615-746-8070
Practice Address - Street 1:212 REN MAR DR
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-9088
Practice Address - Country:US
Practice Address - Phone:615-746-8700
Practice Address - Fax:615-746-8070
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNTN 1887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3973099Medicare ID - Type UnspecifiedMEDICARE
TN3157969OtherCIGNA PROVIDER ID
TNU94327Medicare UPIN
TN11177435OtherCAQH ID #
TN2132836OtherFIRST HEALTH PROVIDER ID
TN4047164OtherBLUE CROSS BLUE SHIELD ID
TN654133OtherUNITED HEALTHCARE ID
TN7397472OtherAETNA PROVIDER ID