Provider Demographics
NPI:1881717817
Name:DOXEY CHIROPRACTIC INC
Entity type:Organization
Organization Name:DOXEY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:D
Authorized Official - Last Name:DOXEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-399-9805
Mailing Address - Street 1:690 12TH ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-5877
Mailing Address - Country:US
Mailing Address - Phone:801-399-9805
Mailing Address - Fax:801-399-9807
Practice Address - Street 1:690 12TH ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-5877
Practice Address - Country:US
Practice Address - Phone:801-399-9805
Practice Address - Fax:801-399-9807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT168560-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT528888147001Medicaid
UT528888147001Medicaid
UT=========OtherTAX ID #
UT000057330Medicare ID - Type Unspecified