Healthcare Provider Details

I. General information

NPI: 1053363051
Provider Name (Legal Business Name): DARRELL RAY EVERHART DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 MAIN ST
FRANKLIN LA
70538-4321
US

IV. Provider business mailing address

204 SANDERS ST
FRANKLIN LA
70538-4217
US

V. Phone/Fax

Practice location:
  • Phone: 337-828-0467
  • Fax: 337-828-7958
Mailing address:
  • Phone: 337-829-1030
  • Fax: 337-828-7958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1338
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: