Provider Demographics
NPI:1225093404
Name:DOPPS, MATTHEW ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ALAN
Last Name:DOPPS
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 1:555 N MCLEAN BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-5847
Mailing Address - Country:US
Mailing Address - Phone:316-265-1575
Mailing Address - Fax:316-425-0222
Practice Address - Street 1:555 N MCLEAN BLVD
Practice Address - Street 2:STE 201
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-5847
Practice Address - Country:US
Practice Address - Phone:316-265-1575
Practice Address - Fax:316-425-0222
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062264OtherBCBS PROVIDER NUMBER