Mathis, Darrel Thomas
Mathis, Darrel Thomas is an sole proprietor health care provider with primary practice located at 279 Sw Main Blvd , Lake City FL 32025-7050. He recently has only one registered license in Chiropractic Providers / Orthopedic, which is considered as his primary health care specialty. Mathis, Darrel Thomas can be contacted via phone (386) 752-4313.Contact Information
Primary practice address
279 Sw Main Blvd
Lake City FL 32025-7050
Phone: (386) 752-4313
Fax: (386) 752-8356
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Orthopedic | 111NX0800X | CH5141 | Florida |
Profile Details
| NPI number | 1679571822 |
|---|---|
| LBN Legal business name | Mathis, Darrel Thomas |
| Credentials | D.C.,F.A.C.O. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Apr 4th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679571822 | NPPES |
| Florida | Other | 350023404 | RAILROAD MEDICARE |
| Florida | MEDICAID | 050782200 | RAILROAD MEDICARE |
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