Provider Demographics
NPI:1912918459
Name:HESKETT, DENNIS LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:LEE
Last Name:HESKETT
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 1:1703 HIGHWAY 121 BYP N
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-8853
Mailing Address - Country:US
Mailing Address - Phone:270-759-1116
Mailing Address - Fax:270-759-1117
Practice Address - Street 1:1703 N. 121 BYPASS
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071
Practice Address - Country:US
Practice Address - Phone:270-759-1116
Practice Address - Fax:270-759-1117
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85040913Medicaid
KY49639OtherANTHEM
KY85040913Medicaid