Dewey Rex Chalk, D.C.
Individual provider Active NPI Chiropractor · Grove Hill, AL
NPI 1376576280 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376576280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 0899 (AL)
- Practice address
- 118 Clark St
Grove Hill, AL 36451 - Phone
- (251) 275-8460
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0899 | AL | Yes |
Addresses
Primary practice location
118 Clark St
Grove Hill, AL 36451
Mailing address
118 Clark St.
P.O. Box 579
Grove Hill, AL 36451
Phone (251) 275-8460
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 70384 | Other | AL | BLUE CROSS-BLUE SHIELD |
Other providers in Grove Hill, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.