Matthews, Endre Dejuan
Matthews, Endre Dejuan is an sole proprietor health care provider with primary practice located at 108 E Northside Dr , Jackson MS 39206-5417. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Matthews, Endre Dejuan can be contacted via phone (601) 366-9005.Contact Information
Primary practice address
108 E Northside Dr
Jackson MS 39206-5417
Phone: (601) 366-9005
Fax: (601) 366-9005
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 1015 | Mississippi |
Profile Details
| NPI number | 1457480469 |
|---|---|
| LBN Legal business name | Matthews, Endre Dejuan |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 5th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 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 | 1457480469 | NPPES |
| Mississippi | MEDICAID | 00125438 |
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