Provider Demographics
NPI:1811975352
Name:LANCASTER, JOHN WILLIAM (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:LANCASTER
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 1:2200 SILAS CREEK PKWY
Mailing Address - Street 2:STE 8A
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103
Mailing Address - Country:US
Mailing Address - Phone:336-727-1800
Mailing Address - Fax:336-727-0057
Practice Address - Street 1:2200 SILAS CREEK PKWY
Practice Address - Street 2:STE 8A
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103
Practice Address - Country:US
Practice Address - Phone:336-727-1800
Practice Address - Fax:336-727-0057
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC814111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8908584Medicaid
T64276Medicare UPIN
244200Medicare ID - Type Unspecified