Provider Demographics
NPI:1043310014
Name:NARANJO, LUIS ALFREDO (DC)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ALFREDO
Last Name:NARANJO
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 1:2475 WINDY HILL RD SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8604
Mailing Address - Country:US
Mailing Address - Phone:770-951-8800
Mailing Address - Fax:770-951-8803
Practice Address - Street 1:2475 WINDY HILL RD SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8604
Practice Address - Country:US
Practice Address - Phone:770-951-8800
Practice Address - Fax:770-951-8803
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002844111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0004636001OtherCIGNA'S INDIVIDUAL #
GA239788OtherBCBS INDIVIDUAL #
GA0004636001OtherCIGNA'S INDIVIDUAL #
GAU23592Medicare UPIN