Pulliam Chiropractic Clinic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

562 Issued in LA

Legal business name

PULLIAM CHIROPRACTIC CLINIC, LLC

Practice address

2055 Gause Blvd E
Suite 300
Slidell, LA 70461-5432

Phone

(985) 649-0023

Fax

(985) 661-9933

NPI assigned

Mar 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Eddie R Pulliam, D.C.NPI 1346386737

Title

Doctor

Phone

(985) 649-0023

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eddie R. Pulliam, D.C.

  • Chiropractor
  • Slidell, LA
  • NPI 1346386737
  Medicare reassignment NPD Authorized official
• Craig James Blalock, DC

  • Chiropractor
  • Slidell, LA
  • NPI 1730159708
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548393473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6776",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704696776",
            "telephone_number": "985-649-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 GAUSE BLVD E",
            "address_2": "SUITE 300",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615432",
            "telephone_number": "985-649-0023",
            "fax_number": "985-661-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULLIAM CHIROPRACTIC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PULLIAM",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "985-649-0023",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD LA",
            "identifier": "3258A",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD LA",
            "identifier": "H6150",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Slidell, LA
• Providers in Slidell, LA by specialty
• Chiropractor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.