=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902952963
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID T NETHERLAND D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/25/2007
-----------------------------------------------------
Last Update Date | 01/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 105 DABBS AVE
-----------------------------------------------------
City | QUITMAN
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39355-2303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-480-0053
-----------------------------------------------------
Fax | 601-776-3512
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 270
-----------------------------------------------------
City | QUITMAN
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39355-0270
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-399-2902
-----------------------------------------------------
Fax | 601-776-3512
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 837
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------