Provider Demographics
NPI:1407223852
Name:HEDGES, CHAD D (DC, MS, CCSP)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:D
Last Name:HEDGES
Suffix:
Gender:M
Credentials:DC, MS, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 DEBARR RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1803
Mailing Address - Country:US
Mailing Address - Phone:907-333-6525
Mailing Address - Fax:907-333-1916
Practice Address - Street 1:6711 DEBARR RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1803
Practice Address - Country:US
Practice Address - Phone:907-333-6525
Practice Address - Fax:907-333-1916
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012864111N00000X
AK125484111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor