DR. RUSSELL HOWARD MAUK DC NPI 1770509929

NPI Information

NPI: 1770509929
Provider Name: DR. RUSSELL HOWARD MAUK, DC
Classification: Chiropractor - 111N00000X
Entity Type: Individual
Address:
8820 GOODMAN RD
OLIVE BRANCH, MS
ZIP 38654
Phone: (662) 890-5454
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DR. Russell Howard Mauk, DC is a chiropractor in Olive Branch, MS. 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. DR. Russell Howard Mauk, DC NPI is 1770509929. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8820 GOODMAN RD
OLIVE BRANCH, MS
ZIP 38654-204
Phone: (662) 890-5454

The enumeration date for this NPI number is 7/14/2006 and was last updated on 10/30/2009.

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		1999	TENNESSEE	No
2	111N00000X	Chiropractor		1079	MISSISSIPPI	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	1174676647	OTHER	MISSISSIPPI	GROUP NPI
2	512G700109	MEDICARE UPIN	MISSISSIPPI
3	V03289	MEDICARE UPIN	MISSISSIPPI
4	350000331	MEDICARE ID-TYPE UNSPECIFIED	MISSISSIPPI
5	02858341	MEDICAID	MISSISSIPPI

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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