Provider Demographics
NPI:1336162882
Name:CLAUSS, CHARLES D (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:D
Last Name:CLAUSS
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:PO BOX 1865
Mailing Address - Street 2:
Mailing Address - City:JENA
Mailing Address - State:LA
Mailing Address - Zip Code:71342-1865
Mailing Address - Country:US
Mailing Address - Phone:318-992-4124
Mailing Address - Fax:318-992-4149
Practice Address - Street 1:2804 NORTH FIRST STREET
Practice Address - Street 2:
Practice Address - City:JENA
Practice Address - State:LA
Practice Address - Zip Code:71342-1865
Practice Address - Country:US
Practice Address - Phone:318-992-4124
Practice Address - Fax:318-992-4149
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA586111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1951811Medicaid
LA2163AOtherBLUE CROSS OF LA
LA1951811Medicaid
LA2163AOtherBLUE CROSS OF LA