Provider Demographics
NPI:1952336505
Name:HALKOVIC, JOSEPH PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PAUL
Last Name:HALKOVIC
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 1:225 MEMPHIS ST
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-3843
Mailing Address - Country:US
Mailing Address - Phone:985-732-3677
Mailing Address - Fax:985-732-3672
Practice Address - Street 1:225 MEMPHIS ST
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3843
Practice Address - Country:US
Practice Address - Phone:985-732-3677
Practice Address - Fax:985-732-3672
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1982750Medicaid
LA384OtherLICENSE
LA59213Medicare ID - Type Unspecified
LA384OtherLICENSE