Provider Demographics
NPI:1346302742
Name:BART, ANTHONY JOHN (DC CCSP)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOHN
Last Name:BART
Suffix:
Gender:M
Credentials:DC CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 EAST PARK STREET
Mailing Address - Street 2:
Mailing Address - City:SHELDON
Mailing Address - State:IA
Mailing Address - Zip Code:51201-1275
Mailing Address - Country:US
Mailing Address - Phone:712-324-4994
Mailing Address - Fax:712-324-3710
Practice Address - Street 1:910 EAST PARK STREET
Practice Address - Street 2:
Practice Address - City:SHELDON
Practice Address - State:IA
Practice Address - Zip Code:51201-1275
Practice Address - Country:US
Practice Address - Phone:712-324-4994
Practice Address - Fax:712-324-3710
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05481111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
9204458OtherGRP DAKOTACARE DESIGN
IA58536OtherWELLMARK BLUE CROSS
7262OtherMIDLANDS CHOICE
21568OtherSIOUX VALLEY HEALTH
IA2294553Medicaid
C05481OtherDAKOTACARE DESIGN
IA17853Medicare ID - Type UnspecifiedGRP
21568OtherSIOUX VALLEY HEALTH
IA2294553Medicaid