Provider Demographics
NPI:1053458711
Name:STERBAN, DOUGLAS SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:SCOTT
Last Name:STERBAN
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 1:260 W MAIN ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3347
Mailing Address - Country:US
Mailing Address - Phone:615-264-8515
Mailing Address - Fax:615-264-8516
Practice Address - Street 1:260 W MAIN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3347
Practice Address - Country:US
Practice Address - Phone:615-264-8515
Practice Address - Fax:615-264-8516
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3670036Medicare PIN