Provider Demographics
NPI:1952428658
Name:MCADOO CHIROPRACTIC CENTER, P.S.C.
Entity Type:Organization
Organization Name:MCADOO CHIROPRACTIC CENTER, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:MCADOO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:270-247-5785
Mailing Address - Street 1:510 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42066-2314
Mailing Address - Country:US
Mailing Address - Phone:270-247-5785
Mailing Address - Fax:270-247-0608
Practice Address - Street 1:510 S 6TH ST
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066-2314
Practice Address - Country:US
Practice Address - Phone:270-247-5785
Practice Address - Fax:270-247-0608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0731301Medicare ID - Type Unspecified