MEDICARE: DR. SHANE C HOYING DC

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	5235	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000703114	OTHER	KY	ANTHEM PIN

General Provider Information

NPI Number	:	1417172123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANE C HOYING DC

Provider Business Mailing Address
First Line	:	2769 W PARK DR
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42001-9058
Country	:	US
Telephone Number	:	270-575-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2769 W PARK DR
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42001-9058
Country	:	US
Telephone Number	:	270-575-1000
Fax Number	:

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/22/2011

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