Three Way Medical Clinic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC0000000708 Issued in TN

Legal business name

THREE WAY MEDICAL CLINIC, LLC

Practice address

400 US Highway 45 W
Humboldt, TN 38343-8503

Phone

(731) 784-0042

Fax

(731) 784-8868

NPI assigned

Nov 29, 2011

Last updated

Feb 13, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ronald Dale Teddleton, D.C.

Title

Owner/Chiropractor

Phone

(731) 784-0042

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1598032963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 US HIGHWAY 45 W",
            "city": "HUMBOLDT",
            "state": "TN",
            "postal_code": "383438503",
            "telephone_number": "731-784-0042",
            "fax_number": "731-784-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 US HIGHWAY 45 W",
            "city": "HUMBOLDT",
            "state": "TN",
            "postal_code": "383438503",
            "telephone_number": "731-784-0042",
            "fax_number": "731-784-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE WAY MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-29",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "TEDDLETON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "731-784-0042",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000000708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.