MEDICARE: DR. STUART SHANNON EPPERSON 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	3121	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285750950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STUART SHANNON EPPERSON D.C.

Provider Business Mailing Address
First Line	:	519 MOHAWK ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43206-1135
Country	:	US
Telephone Number	:	614-314-4317
Fax Number	:	740-364-1095

Provider Business Practice Location Address
First Line	:	974 N 21ST ST
Second Line	:	SUITE C2
City	:	NEWARK
State	:	OH
Zip	:	43055-2990
Country	:	US
Telephone Number	:	740-364-1060
Fax Number	:	740-364-1095

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

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	07/08/2007

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