Provider Demographics
NPI:1780709758
Name:RJ FURY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:RJ FURY CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FURY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:317-578-7700
Mailing Address - Street 1:11501 CUMBERLAND RD
Mailing Address - Street 2:#100
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7005
Mailing Address - Country:US
Mailing Address - Phone:317-578-7700
Mailing Address - Fax:317-577-9355
Practice Address - Street 1:11501 CUMBERLAND RD
Practice Address - Street 2:#100
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7005
Practice Address - Country:US
Practice Address - Phone:317-578-7700
Practice Address - Fax:317-577-9355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001809A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000093147OtherUNICARE
IN000000093147OtherBCBS
INU54844Medicare UPIN
IN069710Medicare ID - Type UnspecifiedMEDICARE