Douglas Brent Garrison, DC

Individual provider Active NPI Chiropractor · Mammoth Spring, AR

NPI 1760410484 · NPPES record last updated Sep 1, 2011

Key facts

NPI
1760410484
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
1368 (AR)
Practice address
350 Bethel Ave
Mammoth Spring, AR 72554-0157
Phone
(870) 625-3355
Fax
(870) 625-3356
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

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 Care Compare profile

Specialty
Chiropractic
Education
Logan College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

350 Bethel Ave
Mammoth Spring, AR 72554-8001
Phone (870) 625-3355

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20041123000726 AR Practitioner - Chiropractic 9234194879 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
006314MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spring River Chiropractic Chiropractor Current
since Apr 15, 2007
Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

350 Main St
Ste 1
Mammoth Spring, AR 72554
Phone (870) 625-3355

350 Bethel Ave
Mammoth Spring, AR 72554
Phone (870) 625-3355

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1368 AR Yes
Chiropractor 111N00000X 006314 MO

Addresses

Primary practice location

350 Bethel Ave
Mammoth Spring, AR 72554-0157

Mailing address

PO Box 157
Mammoth Spring, AR 72554-0157
Phone (870) 625-3355

Other identifiers

IdentifierTypeStateIssuer
132121718MedicaidAR
758899306MedicaidMO

Other providers in Mammoth Spring, AR

All providers in Mammoth Spring, AR · Chiropractor in Arkansas

Sources for this page

Verify at the official NPI Registry.