Provider Demographics
NPI:1194994152
Name:HIXSON CLINIC OF CHIROPRACTIC PC
Entity type:Organization
Organization Name:HIXSON CLINIC OF CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:423-842-1440
Mailing Address - Street 1:5437 HIXSON PIKE
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-3238
Mailing Address - Country:US
Mailing Address - Phone:423-842-1440
Mailing Address - Fax:423-842-1409
Practice Address - Street 1:5437 HIXSON PIKE
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-3238
Practice Address - Country:US
Practice Address - Phone:423-842-1440
Practice Address - Fax:423-842-1409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1482111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4088918OtherBC/BS TN
TN36798851Medicare PIN