Provider Demographics
NPI:1831168137
Name:CARR, JOSEPH N (DC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:N
Last Name:CARR
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 1:2065 CAMPBELL DR
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-3433
Mailing Address - Country:US
Mailing Address - Phone:605-352-5264
Mailing Address - Fax:605-352-9776
Practice Address - Street 1:2065 CAMPBELL DR
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-3433
Practice Address - Country:US
Practice Address - Phone:605-352-5264
Practice Address - Fax:605-352-9776
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD738111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4999852OtherBSSD
SD4999862OtherBSSD
SD7603422Medicaid
SD7603420Medicaid
SD0080145OtherBSSD
SD27919OtherSVHP
SD7603423Medicaid
SDT39585Medicare UPIN
SD7603422Medicaid