Provider Demographics
NPI:1548298078
Name:POLLARD, JACK C (DC)
Entity type:Individual
Prefix:DR
First Name:JACK
Middle Name:C
Last Name:POLLARD
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 1:12 ASHLAND TER
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-4142
Mailing Address - Country:US
Mailing Address - Phone:423-877-3322
Mailing Address - Fax:423-877-2225
Practice Address - Street 1:12 ASHLAND TER
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-4142
Practice Address - Country:US
Practice Address - Phone:423-877-3322
Practice Address - Fax:423-877-2225
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC 270111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4493451OtherAETNA
TN0068642OtherBLUECROSS BLUESHIELD
TN443004OtherCIGNA
TNCP43167OtherUNITED HEALTHCARE
TN443004OtherPROVIDENT
TN4440065OtherUNITED HEALTHCARE COSMOS
TN0068642OtherBLUECROSS BLUESHIELD
TN443004OtherCIGNA
TN4493451OtherAETNA
TN3672617Medicare ID - Type UnspecifiedGRP. #