Provider Demographics
NPI:1053496299
Name:ANNIS, ARTHUR B JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:B
Last Name:ANNIS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5552 CAROLINA BEACH RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2787
Mailing Address - Country:US
Mailing Address - Phone:910-395-5664
Mailing Address - Fax:910-395-5625
Practice Address - Street 1:5552 CAROLINA BEACH RD
Practice Address - Street 2:SUITE F
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2787
Practice Address - Country:US
Practice Address - Phone:910-395-5664
Practice Address - Fax:910-395-5625
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1789111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890821GMedicaid
NC0821GOtherBCBS
NC2446804BMedicare ID - Type Unspecified
U06182Medicare UPIN
NC1053496299Medicare UPIN