MEDICARE: DR. KELLY B. FAIRCLOTH D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	915	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083674402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLY B. FAIRCLOTH D.C.

Provider Business Mailing Address
First Line	:	11 HEYMAN LN
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-3574
Country	:	US
Telephone Number	:	318-448-8462
Fax Number	:	318-448-8486

Provider Business Practice Location Address
First Line	:	11 HEYMAN LN
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-3574
Country	:	US
Telephone Number	:	318-448-8462
Fax Number	:	318-448-8486

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	09/12/2019

Similar Medicare Providers

1528912466 — DR. SOPHIE JEANSONNE DC
Practice Location Address:

11 HEYMAN LN
ALEXANDRIA, LA
71303-3574

Practice Phone: 318-448-8462
Practice Fax:

1629039193 — RIVERSIDE HOSPITAL OF LOUISIANA, INC.
Practice Location Address:

13 HEYMAN LN
ALEXANDRIA, LA
71303-3574

Practice Phone: 318-767-2900
Practice Fax: 318-442-4505

1619915667 — TRI-PARISH RENTAL, INC.
Practice Location Address:

21A HEYMAN LN
ALEXANDRIA, LA
71303-3574

Practice Phone: 318-448-8663
Practice Fax: 318-442-3311

1356379317 — DR. WILLIAM FOSTER HENSEL DDS
Practice Location Address:

11 HEYMAN LN
ALEXANDRIA, LA
71303-3574

Practice Phone: 318-445-0419
Practice Fax:

1932401510 — PRAXAIR HEALTHCARE SERVICES, INC
Practice Location Address:

21A HEYMAN LN
ALEXANDRIA, LA
71303-3574

Practice Phone: 318-442-1133
Practice Fax: 318-442-3311

1215235809 — APRIA HEALTHCARE LLC
Practice Location Address:

21A HEYMAN LN
ALEXANDRIA, LA
71303-3574

Practice Phone: 318-442-1133
Practice Fax: 318-442-3311

Directions to “ DR. KELLY B. FAIRCLOTH D.C.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.