=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740228667
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARKHAM CHIROPRACTIC CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2006
-----------------------------------------------------
Last Update Date | 04/19/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 707 WHITLOCK AVE SW STE E18
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30064-3098
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-523-8650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 707 WHITLOCK AVE SW STE E18
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30064-3098
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-523-8650
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JOHN FRANCIS MARKHAM III
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 678-523-8650
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 1899
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------