BRIAN KEITH WATERS (NPI# 1851944607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851944607 |
| Entity Type | Individual |
| Full Name | BRIAN KEITH WATERS |
| Credential | D.C. |
| Practice Address |
403 Ward St W Douglas GA 31533-3505 |
| Mailing Address |
6257 Old Axson Rd Douglas GA 31535-3429 |
| Practice Telephone | 9122600005 |
| Mailing Telephone | 9123143023 |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2020-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CHIR008092 | GA | Chiropractic Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 362 S Main St Ste A, Baxley, GA 315130187 | 9127054321 | 9127054322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154543684 | Brian Michael Waters | Psychiatry & Neurology | 2200 Bergquist Drive, Wilford Hall Medical Center, Lackland Afb, TX 78236-5300 | 2007-05-03 |
| Street Address |
403 WARD ST W |
| City | DOUGLAS |
| State | GA |
| Zip Code | 31533-3505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134737778 | Blue Waters Wellness LLC | Chiropractor | 403 Ward St W, Douglas, GA 31533-3505 | 2020-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1811528649 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 North Street, Douglas, GA 31533 | 2020-01-30 |
| 1952940793 | Teresa Smith | Pharmacist | 901 W Ward St, Douglas, GA 31533 | 2019-12-26 |
| 1447641048 | Jennifer Spivey | Nurse Practitioner | 326 Shirley Avenue, Douglas, GA 31533 | 2015-02-18 |
| 1972914497 | Jessica Lynne Courson | Nurse Practitioner | 903 West Ward Street, Suite B, Douglas, GA 31533 | 2014-05-19 |
| 1063840296 | South Central Primary Care Center | Clinic/Center | 303 Shirley Ave, Ste B, Douglas, GA 31533 | 2013-10-25 |
| 1336411008 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 118 Coweta Avenue South, Douglas, GA 31533 | 2012-01-27 |
| 1346482700 | V and V Clinic | Pediatrics | 1020 West Bryan Street, Douglas, GA 31533 | 2009-04-01 |
| 1063650406 | Jayla Snipes Bullock | Speech-Language Pathologist | 618 Bowens Mill Road Sw, Douglas, GA 31533 | 2009-01-22 |
| 1417112707 | Southern Community Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 315 S. Gaskin Ave, Douglas, GA 31533 | 2008-07-25 |
| Find all providers in zip 31533 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275187403 | Coffee Chiropractic LLC | Chiropractor | 1214 Peterson Ave N Ste P, Douglas, GA 31533-2835 | 2019-07-25 |
| 1417249343 | Joshua Brett Mizell | Chiropractor | 506 Ashley St W, Douglas, GA 31533-2308 | 2011-05-11 |
| 1730485509 | Henry Randall Sheffield | Chiropractor | 410 Ward St E, Douglas, GA 31533-0001 | 2011-01-26 |
| 1477736015 | Ediss Chiropractic, Inc | Chiropractor | 1330 E Richards St, Douglas, WY 82633-2951 | 2007-12-05 |
| 1538360888 | Jay Daniel Zamora | Chiropractor | 1915 E 10th St, Douglas, AZ 85607 | 2007-05-31 |
| 1770612079 | Robert D Keeler | Chiropractor | 1843 Madora Ave, Douglas, WY 82633-3059 | 2007-03-04 |
| 1720139363 | Larry Hutchison | Chiropractor | 1103 Madison Ave N, Douglas, GA 31533-2803 | 2007-01-12 |
| 1669521324 | Stephan Paul Ediss | Chiropractor | 1330 E. Richards, Douglas, WY 82633 | 2007-01-10 |
| 1699843417 | Brent E Miller | Chiropractor | 410 E Ward St, Douglas, GA 31533 | 2006-12-01 |
| 1568402055 | Douglas Chiropractic | Chiropractor | 105 Shirley Ave, Douglas, GA 31533-2325 | 2006-06-07 |
| Find all providers in DOUGLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.