Betty Jean Desjarlais, D.C.

Individual provider Active NPI Chiropractor · Mayfield, KY

NPI 1316960743 · NPPES record last updated Nov 15, 2013

Key facts

NPI
1316960743
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
5214 (KY)
Practice address
118 W Broadway
Mayfield, KY 42066-2214
Phone
(270) 247-2121
Fax
(270) 247-2127
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5214KYMDChiropractor
2856NCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Chiropractic Clinic Chiropractor Past
since Jun 7, 1999
Accepting new patients
Mayfield Chiropractic Wellness Center,PLLC Chiropractor Past
since Jan 12, 2010
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5214 KY Yes

Addresses

Primary practice location

118 W Broadway
Mayfield, KY 42066-2214

Mailing address

118 West Bdwy
Mayfield, KY 42066-2314
Phone (270) 247-2121

Other providers in Mayfield, KY

All providers in Mayfield, KY · Chiropractor in Kentucky

Sources for this page

Verify at the official NPI Registry.