Provider Demographics
NPI:1396814661
Name:LUSHINSKY, DAVID ALLEN (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALLEN
Last Name:LUSHINSKY
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 1:2976 N SCATTERFIELD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012-1585
Mailing Address - Country:US
Mailing Address - Phone:765-643-8781
Mailing Address - Fax:765-622-0126
Practice Address - Street 1:2976 N SCATTERFIELD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-1585
Practice Address - Country:US
Practice Address - Phone:765-643-8781
Practice Address - Fax:765-622-0126
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001691A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200473220AMedicaid
IN000000323449OtherANTHEM BCBS PIN NUMBER
IN000000323449OtherANTHEM BCBS PIN NUMBER