=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922947688
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARCOS PADILLA DC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2026
-----------------------------------------------------
Last Update Date | 03/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1575 LAWRENCEVILLE HWY STE A
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30044-2006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-900-0000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1025 CALLE TOPACIO
-----------------------------------------------------
City | BARCELONETA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00617-2950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CHIR066653
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------