Provider Demographics
NPI:1871564229
Name:ESPELAND, CHAD RICHARD (DC)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:RICHARD
Last Name:ESPELAND
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 1:1201 HIGHWAY 49 S
Mailing Address - Street 2:SUITE 34
Mailing Address - City:RICHLAND
Mailing Address - State:MS
Mailing Address - Zip Code:39218-9438
Mailing Address - Country:US
Mailing Address - Phone:601-936-6940
Mailing Address - Fax:601-936-9930
Practice Address - Street 1:1201 HIGHWAY 49 S
Practice Address - Street 2:SUITE 34
Practice Address - City:RICHLAND
Practice Address - State:MS
Practice Address - Zip Code:39218-9438
Practice Address - Country:US
Practice Address - Phone:601-936-6940
Practice Address - Fax:601-936-9930
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS946111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00119455Medicaid
C02264Medicare PIN
U67877Medicare UPIN