Provider Demographics
NPI:1386652360
Name:WHITTEN, EULEN C JR (DC)
Entity type:Individual
Prefix:DR
First Name:EULEN
Middle Name:C
Last Name:WHITTEN
Suffix:JR
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 1:104 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850
Mailing Address - Country:US
Mailing Address - Phone:308-324-5948
Mailing Address - Fax:308-324-4703
Practice Address - Street 1:104 W 7TH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850
Practice Address - Country:US
Practice Address - Phone:308-324-5948
Practice Address - Fax:308-324-4703
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE846111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47071839300Medicaid
NEBCBS77780OtherBLUE CROSS BLUE SHIELD NE
NEBCBS77780OtherBLUE CROSS BLUE SHIELD NE