Provider Demographics
NPI:1114948882
Name:CHAFFIN, BRIAN DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DEAN
Last Name:CHAFFIN
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 1:1505 AIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-4321
Mailing Address - Country:US
Mailing Address - Phone:405-273-2202
Mailing Address - Fax:405-273-2292
Practice Address - Street 1:1505 AIRPORT DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-4321
Practice Address - Country:US
Practice Address - Phone:405-273-2202
Practice Address - Fax:405-273-2292
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V04227Medicare UPIN