MEDICARE: JOE M. LEVERETT 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	DC7306	TX
2	171100000X	Acupuncturist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	350042209	OTHER		RAILROAD MEDICARE

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	:	1467472563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE M. LEVERETT D. C.

Provider Business Mailing Address
First Line	:	PO BOX 486
Second Line	:
City	:	GOLDTHWAITE
State	:	TX
Zip	:	76844-0486
Country	:	US
Telephone Number	:	325-648-2644
Fax Number	:	325-648-2337

Provider Business Practice Location Address
First Line	:	1120 FISHER ST.
Second Line	:
City	:	GOLDTHWAITE
State	:	TX
Zip	:	76844
Country	:	US
Telephone Number	:	325-648-2644
Fax Number	:	325-648-2337

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	11/04/2010

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