MEDICARE: GERALD WAYNE JOINES II 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	4458	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000069432	OTHER	KY	ANTHEM BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134224140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERALD WAYNE JOINES II DC

Provider Business Mailing Address
First Line	:	1731 W EVERLY BROS BLVD
Second Line	:
City	:	CENTRAL CITY
State	:	KY
Zip	:	42330
Country	:	US
Telephone Number	:	270-754-1335
Fax Number	:	270-757-9478

Provider Business Practice Location Address
First Line	:	1731 W EVERLY BROS BLVD
Second Line	:
City	:	CENTRAL CITY
State	:	KY
Zip	:	42330
Country	:	US
Telephone Number	:	270-754-1335
Fax Number	:	270-757-9478

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	07/08/2007

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