Provider Demographics
NPI:1568460038
Name:SCHOENHOFER, DOUGLAS J (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:J
Last Name:SCHOENHOFER
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 1:402 N ROSE HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROSE HILL
Mailing Address - State:KS
Mailing Address - Zip Code:67133-9499
Mailing Address - Country:US
Mailing Address - Phone:316-776-0555
Mailing Address - Fax:316-776-2391
Practice Address - Street 1:402 N ROSE HILL RD
Practice Address - Street 2:
Practice Address - City:ROSE HILL
Practice Address - State:KS
Practice Address - Zip Code:67133-9499
Practice Address - Country:US
Practice Address - Phone:316-776-0555
Practice Address - Fax:316-776-2391
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04134111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS060040OtherBLUE CROSS BLUE SHIELD
KSU37364Medicare UPIN
KS060040SCMedicare ID - Type Unspecified