Provider Demographics
NPI:1427278654
Name:FAUST, ERNEST KENDALL (DC)
Entity type:Individual
Prefix:
First Name:ERNEST
Middle Name:KENDALL
Last Name:FAUST
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 1:1912 COLUMBIA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3950
Mailing Address - Country:US
Mailing Address - Phone:615-794-1075
Mailing Address - Fax:
Practice Address - Street 1:1912 COLUMBIA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3950
Practice Address - Country:US
Practice Address - Phone:615-794-1075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T74802Medicare UPIN
3671618Medicare ID - Type Unspecified