Dr Leslie Kevin Ethridge, DC is a medicare enrolled "Chiropractor - Neurology" provider in Newton, Mississippi. His current practice location is
124 Ford Ave, Newton, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 527-9707.
Dr Leslie Kevin Ethridge is licensed to practice in Mississippi (license number 1209) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1598197584.
Healthcare Provider's Profile
| Full Name | Dr Leslie Kevin Ethridge |
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| Gender | Male |
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| Speciality | Chiropractor - Neurology |
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| Location | 124 Ford Ave, Newton, Mississippi |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1598197584
- Provider Enumeration Date: 08/01/2013
- Last Update Date: 08/01/2013
Medicare PECOS Information:
- PECOS PAC ID: 2264655075
- Enrollment ID: I20140523001800
Medical Identifiers
Medical identifiers for Dr Leslie Kevin Ethridge such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1598197584 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | 1209 (Mississippi) | Secondary |
| 111NN0400X | Chiropractor - Neurology | 1209 (Mississippi) | Primary |
| 111NN1001X | Chiropractor - Nutrition | 1209 (Mississippi) | Secondary |
| 111NP0017X | Chiropractor - Pediatric Chiropractor | 1209 (Mississippi) | Secondary |
| 111NR0200X | Chiropractor - Radiology | 1209 (Mississippi) | Secondary |
| 111NR0400X | Chiropractor - Rehabilitation | 1209 (Mississippi) | Secondary |
| 111NS0005X | Chiropractor - Sports Physician | 1209 (Mississippi) | Secondary |
| 111NT0100X | Chiropractor - Thermography | 1209 (Mississippi) | Secondary |
| 111NX0100X | Chiropractor - Occupational Health | 1209 (Mississippi) | Secondary |
| 111NX0800X | Chiropractor - Orthopedic | 1209 (Mississippi) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Leslie Kevin Ethridge is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Leslie Kevin Ethridge, DC
124 Ford Ave,
Newton, MS 39345-2222
Ph: (601) 527-9707 | Dr Leslie Kevin Ethridge, DC
124 Ford Ave,
Newton, MS 39345-2222
Ph: (601) 527-9707 |
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