Provider Demographics
NPI:1225143944
Name:FENDER, STEVE K (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:K
Last Name:FENDER
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 1:2116 EAST KIEHL AVE
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120
Mailing Address - Country:US
Mailing Address - Phone:501-834-2060
Mailing Address - Fax:501-834-2762
Practice Address - Street 1:2116 EAST KIEHL AVE
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120
Practice Address - Country:US
Practice Address - Phone:501-834-2060
Practice Address - Fax:501-834-2762
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR899111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59202Medicare ID - Type Unspecified
T20607Medicare UPIN