Provider Demographics
NPI:1932191384
Name:HAVEN, JOSEPH SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SCOTT
Last Name:HAVEN
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 1:92 MAIN ST
Mailing Address - Street 2:STE D
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-1754
Mailing Address - Country:US
Mailing Address - Phone:843-342-3878
Mailing Address - Fax:
Practice Address - Street 1:92 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-1754
Practice Address - Country:US
Practice Address - Phone:843-342-3333
Practice Address - Fax:843-423-3367
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2079111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU84558Medicare UPIN