| Campbellsburg Chiropractic, Psc | |
|
8172 Main St Campbellsburg KY 40011-0293 | |
| (502) 532-0099 | |
| (502) 532-0096 |
| Full Name | Campbellsburg Chiropractic, Psc |
|---|---|
| Speciality | Chiropractor |
| Location | 8172 Main St, Campbellsburg, Kentucky |
| Authorized Official Name and Position | Mark Everett Hines (OWNER) |
| Authorized Official Contact | 5025320099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Campbellsburg Chiropractic, Psc 8172 Main St Po Box 293 Campbellsburg KY 40011-0293 Ph: (502) 532-0099 | Campbellsburg Chiropractic, Psc 8172 Main St Campbellsburg KY 40011-0293 Ph: (502) 532-0099 |
| NPI Number | 1699980383 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 10/13/2010 |
| Medicare PECOS PAC ID | 9638147390 |
|---|---|
| Medicare Enrollment ID | O20040921000018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699980383 | NPI | - | NPPES |
| 8500359800 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4721 (Kentucky) | Secondary |
| 111N00000X | Chiropractor | 4721 (Kentucky) | Primary |
| Provider Name | Mark E Hines |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1871537316 PECOS PAC ID: 7618945379 Enrollment ID: I20040922000032 |
| Provider Name | Brent M Dawson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1780032342 PECOS PAC ID: 9032402177 Enrollment ID: I20160726003212 |
| Provider Name | Jacob K Langston |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1558874784 PECOS PAC ID: 1951668201 Enrollment ID: I20171122000686 |
| Provider Name | Jenna E Langston |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1902318017 PECOS PAC ID: 9537420351 Enrollment ID: I20190221000150 |
| Provider Name | Catherine Alyxandria Webb |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1316523970 PECOS PAC ID: 1355758905 Enrollment ID: I20210325002064 |