Provider Demographics
NPI:1215751797
Name:DANGERFIELD, JAXSON E (DC)
Entity type:Individual
Prefix:
First Name:JAXSON
Middle Name:E
Last Name:DANGERFIELD
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 1:3153 CAHABA HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5246
Mailing Address - Country:US
Mailing Address - Phone:205-537-7463
Mailing Address - Fax:205-967-0408
Practice Address - Street 1:3166 ALLISON BONNETT MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:HUEYTOWN
Practice Address - State:AL
Practice Address - Zip Code:35023-1641
Practice Address - Country:US
Practice Address - Phone:205-537-7463
Practice Address - Fax:205-967-0408
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2874111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor