Dr Jesse Elijah Mccord, DC | |
1927 Highway 138 Ne Ste 500, Conyers, GA 30013-1254 | |
(770) 860-8333 | |
Not Available |
Full Name | Dr Jesse Elijah Mccord |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 1927 Highway 138 Ne Ste 500, Conyers, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871306365 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CHIR011320 (Georgia) | Primary |
Provider Name | Thacker Chiropractic Clinic, Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1255489712 PECOS PAC ID: 9739160300 Enrollment ID: O20040528000454 |
Mailing Address | Practice Location Address |
---|---|
Dr Jesse Elijah Mccord, DC 4169 Dorchester Dr Se, Covington, GA 30014-3137 Ph: () - | Dr Jesse Elijah Mccord, DC 1927 Highway 138 Ne Ste 500, Conyers, GA 30013-1254 Ph: (770) 860-8333 |
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