Provider Demographics
NPI:1962410944
Name:PRIMEAUX, CHRIS (DC)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:PRIMEAUX
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:PO BOX 1610
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71802-1610
Mailing Address - Country:US
Mailing Address - Phone:870-777-3100
Mailing Address - Fax:870-777-3286
Practice Address - Street 1:3RD & EDGEWOOD
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801
Practice Address - Country:US
Practice Address - Phone:870-777-3100
Practice Address - Fax:870-777-3286
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR115497718Medicaid
AR59674OtherBCBS
AR59674OtherBCBS
AR115497718Medicaid