Provider Demographics
NPI:1083619357
Name:ANTHONY, DENNIS L (DC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:L
Last Name:ANTHONY
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 1:3017 W 6TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-2364
Mailing Address - Country:US
Mailing Address - Phone:785-841-2218
Mailing Address - Fax:785-841-8538
Practice Address - Street 1:3017 W 6TH ST
Practice Address - Street 2:STE A
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-2364
Practice Address - Country:US
Practice Address - Phone:785-841-2218
Practice Address - Fax:785-841-8538
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0103590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0005451OtherBCBS
KS227S4014OtherBCBSKC
KS062506OtherBCBS
KS9552057301Medicaid
KS005451OtherBCBS
KSKA1100002Medicare PIN
KS9552057301Medicaid
KS227S4014OtherBCBSKC