GHOLSON CHIROPRACTIC LIFE & HEALTH LTD NPI 1457458697

NPI Information

NPI: 1457458697
Provider Name: GHOLSON CHIROPRACTIC LIFE & HEALTH LTD
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
1624 W MAIN ST
CARMI, IL
ZIP 62821
Phone: (618) 384-3621
Get Directions

GHOLSON CHIROPRACTIC LIFE & HEALTH LTD is a chiropractor in Carmi, IL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. GHOLSON CHIROPRACTIC LIFE & HEALTH LTD NPI is 1457458697. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1624 W MAIN ST
CARMI, IL
ZIP 62821-235
Phone: (618) 384-3621
Fax: (618) 384-2908

The provider's authorized official is Travis Rhine Gholson .
The authorized official title is Doctor Of Chiropractic and has the following contact phone number (618) 384-2631.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 8/19/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor		038008660	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	038008660	MEDICAID	ILLINOIS
2	09726159	OTHER	ILLINOIS	BLUE CROSS SHIELD IL
3	U79242	MEDICARE UPIN
4	573380	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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