MEDICARE: MR. RODNEY D HERRING 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	1176	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51000722	OTHER	AL	BLUE CROSS

General Provider Information

NPI Number	:	1447278692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RODNEY D HERRING DC

Provider Business Mailing Address
First Line	:	2011 GATEWAY DR
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-6836
Country	:	US
Telephone Number	:	334-745-5321
Fax Number	:	334-745-5358

Provider Business Practice Location Address
First Line	:	2011 GATEWAY DR
Second Line	:
City	:	OPELIKA
State	:	AL
Zip	:	36801-6836
Country	:	US
Telephone Number	:	334-745-5321
Fax Number	:	334-745-5358

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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