Provider Demographics
NPI:1023056785
Name:NORTHSIDE CHIROPRACTIC
Entity type:Organization
Organization Name:NORTHSIDE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:865-690-4200
Mailing Address - Street 1:2905 TAZEWELL PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-1874
Mailing Address - Country:US
Mailing Address - Phone:865-686-1600
Mailing Address - Fax:865-686-3380
Practice Address - Street 1:2905 TAZEWELL PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-1874
Practice Address - Country:US
Practice Address - Phone:865-686-1600
Practice Address - Fax:865-686-3380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3971505Medicare ID - Type Unspecified