Provider Demographics
NPI:1962549865
Name:COMBS, EVERETT A (DC)
Entity type:Individual
Prefix:DR
First Name:EVERETT
Middle Name:A
Last Name:COMBS
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 1:1000 N STATE ROAD 135
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1317
Mailing Address - Country:US
Mailing Address - Phone:317-888-0634
Mailing Address - Fax:317-889-9802
Practice Address - Street 1:1000 N STATE ROAD 135
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1317
Practice Address - Country:US
Practice Address - Phone:317-888-0634
Practice Address - Fax:317-889-9802
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000582A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100154560AMedicaid
IN100154560AMedicaid
IN439550AMedicare ID - Type Unspecified
IN4402541Medicare UPIN