MEDICARE: DR. ERIC E CARSON D.C.

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	1317	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350044754	OTHER	AR	RR MEDICARE

General Provider Information

NPI Number	:	1225025778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC E CARSON D.C.

Provider Business Mailing Address
First Line	:	132 MEYERS CREEK RD
Second Line	:
City	:	ROYAL
State	:	AR
Zip	:	71968-9304
Country	:	US
Telephone Number	:	870-867-0172
Fax Number	:	501-701-4050

Provider Business Practice Location Address
First Line	:	307 N GEORGE ST.
Second Line	:
City	:	MOUNT IDA
State	:	AR
Zip	:	71957
Country	:	US
Telephone Number	:	870-867-0172
Fax Number	:	501-701-4050

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	02/02/2022

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Directions to “ DR. ERIC E CARSON D.C.” Practice Location

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