Provider Demographics
NPI:1487868667
Name:PITT, DOUGLAS OWENS (DC)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:OWENS
Last Name:PITT
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 1:764 E GLENN AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5017
Mailing Address - Country:US
Mailing Address - Phone:334-501-4691
Mailing Address - Fax:334-501-4693
Practice Address - Street 1:764 E GLENN AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5017
Practice Address - Country:US
Practice Address - Phone:334-501-4691
Practice Address - Fax:334-501-4693
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1848111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU78418Medicare UPIN