Provider Demographics
NPI:1265627905
Name:MCGEHEE CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:MCGEHEE CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:MCGEHEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-329-4664
Mailing Address - Street 1:2104 HARKRIDER ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-2820
Mailing Address - Country:US
Mailing Address - Phone:501-329-4664
Mailing Address - Fax:501-329-4619
Practice Address - Street 1:2104 HARKRIDER ST
Practice Address - Street 2:SUITE 104
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-2820
Practice Address - Country:US
Practice Address - Phone:501-329-4664
Practice Address - Fax:501-329-4619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1457111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARU66266Medicare UPIN