Provider Demographics
NPI:1528017704
Name:HIXON, DENVER ALAN (DC)
Entity Type:Individual
Prefix:MR
First Name:DENVER
Middle Name:ALAN
Last Name:HIXON
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 1:2305 SPRINGHILL RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72019-7552
Mailing Address - Country:US
Mailing Address - Phone:501-847-3373
Mailing Address - Fax:501-847-3370
Practice Address - Street 1:2305 SPRINGHILL RD
Practice Address - Street 2:STE. 10
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72019-7552
Practice Address - Country:US
Practice Address - Phone:501-847-3373
Practice Address - Fax:501-847-3370
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1536111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5U743Medicare ID - Type Unspecified