Provider Demographics
NPI:1477624690
Name:ARBUCKLE, STEPHEN ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ROBERT
Last Name:ARBUCKLE
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 1:298 E END AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2808
Mailing Address - Country:US
Mailing Address - Phone:724-775-0600
Mailing Address - Fax:724-775-6775
Practice Address - Street 1:298 E END AVE
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2808
Practice Address - Country:US
Practice Address - Phone:724-775-0600
Practice Address - Fax:724-775-6775
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008062L111N00000X
PAAJ008505111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASA1035801OtherHEALTH AMERICA
PA9429171OtherCIGNA
PA1395969OtherHIGHMARK BCBS
PA7548436OtherAETNA
PA9429171OtherCIGNA
PA7548436OtherAETNA