Provider Demographics
NPI:1104161504
Name:ERHABOR, CALVIN (DC)
Entity type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:
Last Name:ERHABOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 U S HIGHWAY 49
Mailing Address - Street 2:SUITE 15
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-7585
Mailing Address - Country:US
Mailing Address - Phone:601-317-6633
Mailing Address - Fax:
Practice Address - Street 1:5910 U S HIGHWAY 49
Practice Address - Street 2:SUITE 15
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-7585
Practice Address - Country:US
Practice Address - Phone:601-317-6633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor