Provider Demographics
NPI:1255365649
Name:MARKSON, ERIC TODD (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:TODD
Last Name:MARKSON
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 1:10078 NW 1ST CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7035
Mailing Address - Country:US
Mailing Address - Phone:954-472-7975
Mailing Address - Fax:954-472-7941
Practice Address - Street 1:10078 NW 1ST CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7035
Practice Address - Country:US
Practice Address - Phone:954-472-7975
Practice Address - Fax:954-472-7941
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH0007064OtherSTATE LICENSE NUMBER
FL55380OtherBLUE CROSS/BLUE SHIELD
FLCH0007064OtherSTATE LICENSE NUMBER
FLU59681Medicare UPIN