Provider Demographics
NPI:1376510768
Name:ABSHIRE, JASON P (DC, CCSP)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:P
Last Name:ABSHIRE
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 S. COLLEGE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503
Mailing Address - Country:US
Mailing Address - Phone:337-261-0100
Mailing Address - Fax:337-261-5589
Practice Address - Street 1:913 S COLLEGE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3060
Practice Address - Country:US
Practice Address - Phone:337-261-0100
Practice Address - Fax:337-261-5589
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1277111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAU88811Medicare UPIN
LA4C109 CD61Medicare ID - Type Unspecified