Provider Demographics
NPI:1386672590
Name:HEDMAN, DAVID A (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:HEDMAN
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 1:1815 E SANTA FE ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030-2500
Mailing Address - Country:US
Mailing Address - Phone:913-884-2057
Mailing Address - Fax:913-938-5246
Practice Address - Street 1:1815 E SANTA FE ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:KS
Practice Address - Zip Code:66030-2500
Practice Address - Country:US
Practice Address - Phone:913-884-2057
Practice Address - Fax:913-938-5246
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS005462OtherBLUECROSS BLUESHIELD KS
KSCS7033OtherRAILROAD MEDICARE
KS005462Medicare ID - Type Unspecified
KS005462OtherBLUECROSS BLUESHIELD KS