Provider Demographics
NPI:1568472751
Name:PETERSON, ARTHUR DARWIN (DC)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:DARWIN
Last Name:PETERSON
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 1:3933 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:SUITE E-400
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8761
Mailing Address - Country:US
Mailing Address - Phone:512-338-8808
Mailing Address - Fax:512-338-8815
Practice Address - Street 1:3933 SPICEWOOD SPRINGS RD
Practice Address - Street 2:SUITE E-400
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8761
Practice Address - Country:US
Practice Address - Phone:512-338-8808
Practice Address - Fax:512-338-8815
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2750111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601496OtherMEDICARE PTAN
TX601496OtherMEDICARE PTAN
1568472751Medicare PIN
1568472751Medicare PIN