Provider Demographics
NPI:1023016425
Name:BACKUS, DAVID K (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:BACKUS
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 1:13576 W CAMINO DEL SOL STE 23
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4428
Mailing Address - Country:US
Mailing Address - Phone:623-544-0200
Mailing Address - Fax:623-466-0624
Practice Address - Street 1:13576 W CAMINO DEL SOL STE 23
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4428
Practice Address - Country:US
Practice Address - Phone:623-544-0200
Practice Address - Fax:623-466-0624
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0443530OtherBCBS
AZV05162Medicare UPIN
AZZ112382Medicare PIN