Provider Demographics
NPI:1699956169
Name:MKF CHIROPRACTIC, PSC
Entity type:Organization
Organization Name:MKF CHIROPRACTIC, PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-380-1210
Mailing Address - Street 1:5538 NEW CUT RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-4330
Mailing Address - Country:US
Mailing Address - Phone:502-380-1210
Mailing Address - Fax:502-380-1646
Practice Address - Street 1:5538 NEW CUT RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-4330
Practice Address - Country:US
Practice Address - Phone:502-380-1210
Practice Address - Fax:502-380-1646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4939111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2686081000OtherPASSPORT ADVANTAGE
KY000000335379OtherACORDIA OF LOUISVILLE
KY85900447Medicaid
KY9107OtherMEDICARE GROUP
KY000000335379OtherACORDIA OF LOUISVILLE
KY0910702Medicare PIN