Provider Demographics
NPI:1487715892
Name:ANDERSON, ARTHUR CHARLES (DC)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:CHARLES
Last Name:ANDERSON
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:PO BOX 21
Mailing Address - Street 2:1041 HWY 231 N
Mailing Address - City:HARTFORD
Mailing Address - State:KY
Mailing Address - Zip Code:42347
Mailing Address - Country:US
Mailing Address - Phone:270-298-7635
Mailing Address - Fax:270-298-7695
Practice Address - Street 1:1041 HWY 231 N
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:KY
Practice Address - Zip Code:42347
Practice Address - Country:US
Practice Address - Phone:270-298-7635
Practice Address - Fax:270-298-7695
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3113111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6003001Medicare ID - Type Unspecified
T54221Medicare UPIN