Provider Demographics
NPI:1497740179
Name:DONCHEFF, ANTHONY IWAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:IWAN
Last Name:DONCHEFF
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 1:75 HIGHWAY 62 412
Mailing Address - Street 2:SUITE G
Mailing Address - City:ASH FLAT
Mailing Address - State:AR
Mailing Address - Zip Code:72513-9594
Mailing Address - Country:US
Mailing Address - Phone:870-994-2888
Mailing Address - Fax:
Practice Address - Street 1:75 HIGHWAY 62 412
Practice Address - Street 2:SUITE G
Practice Address - City:ASH FLAT
Practice Address - State:AR
Practice Address - Zip Code:72513-9594
Practice Address - Country:US
Practice Address - Phone:870-994-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1066111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR180489718Medicaid
AR59009OtherMEDICARE ID
ART20514Medicare UPIN