Provider Demographics
NPI:1558630939
Name:CURTIS A. ANDERSON, PA
Entity Type:Organization
Organization Name:CURTIS A. ANDERSON, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:AUBREY
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-892-7432
Mailing Address - Street 1:2574 US HIGHWAY 90 W
Mailing Address - Street 2:
Mailing Address - City:DEFUNIAK SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32433-6733
Mailing Address - Country:US
Mailing Address - Phone:850-892-7432
Mailing Address - Fax:
Practice Address - Street 1:2574 US HIGHWAY 90 W
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32433-6733
Practice Address - Country:US
Practice Address - Phone:850-892-7432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5554111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T-84561Medicare UPIN