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NPI Code Detail

MEDICARE: DR. JOE ALAN DIRKER D.C.

MEDICARE: DR. JOE ALAN DIRKER 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
1111N00000XChiropractor3361WI

Other Identifiers

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

General Provider Information

NPI Number : 1356340418
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOE ALAN DIRKER D.C.
Provider Business Mailing Address
First Line : 909 S TAYLOR DR
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53081-4766
Country : US
Telephone Number : 920-451-7000
Fax Number : 920-451-7100
Provider Business Practice Location Address
First Line : 909 S TAYLOR DR
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53081-4766
Country : US
Telephone Number : 920-451-7000
Fax Number : 920-451-7100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 04/18/2012

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