Provider Demographics
NPI:1396832812
Name:RUDD, ARVIL LONNIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ARVIL
Middle Name:LONNIE
Last Name:RUDD
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 1:6220 ANTIOCH RD
Mailing Address - Street 2:STE 200
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-5107
Mailing Address - Country:US
Mailing Address - Phone:913-722-1113
Mailing Address - Fax:913-722-2677
Practice Address - Street 1:6220 ANTIOCH RD
Practice Address - Street 2:STE 200
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-5107
Practice Address - Country:US
Practice Address - Phone:913-722-1113
Practice Address - Fax:913-722-2677
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00220339OtherRAILROAD MEDICARE
33911023OtherBLUE CROSS BLUE SHIELD
KSR12D174Medicare ID - Type Unspecified