MEDICARE: DR. MATTHEW C. HUNEYCUTT 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	1621	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00144384	OTHER	AR	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5X997	OTHER	AR	BLUE CROSS BLUE SHIELD
2	7470597	OTHER	AR	AETNA
4	2222627	OTHER	AR	FIRST HEALTH

General Provider Information

NPI Number	:	1417962721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW C. HUNEYCUTT D.C.

Provider Business Mailing Address
First Line	:	25255 HIGHWAY 5
Second Line	:	STE K
City	:	LONSDALE
State	:	AR
Zip	:	72087-9102
Country	:	US
Telephone Number	:	501-568-6612
Fax Number	:	501-568-7454

Provider Business Practice Location Address
First Line	:	7117 GEYER SPRINGS RD
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72209-3644
Country	:	US
Telephone Number	:	501-568-6612
Fax Number	:	501-568-7454

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

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	06/21/2016

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