Provider Demographics
NPI:1043306434
Name:ZEAGLER, JON ERIC (DC)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:ERIC
Last Name:ZEAGLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-5053
Mailing Address - Country:US
Mailing Address - Phone:318-352-0099
Mailing Address - Fax:318-352-1032
Practice Address - Street 1:366 SOUTH DR
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-5053
Practice Address - Country:US
Practice Address - Phone:318-352-0099
Practice Address - Fax:318-352-1032
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1232111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CD97Medicare ID - Type UnspecifiedPROVIDER #