Provider Demographics
NPI:1568667244
Name:ALAN RICHARD PAPENHEIM DC
Entity Type:Organization
Organization Name:ALAN RICHARD PAPENHEIM DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:PAPENHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-684-1484
Mailing Address - Street 1:PO BOX 5883
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34611-5883
Mailing Address - Country:US
Mailing Address - Phone:352-683-3993
Mailing Address - Fax:352-683-3994
Practice Address - Street 1:11046 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-5048
Practice Address - Country:US
Practice Address - Phone:352-683-3993
Practice Address - Fax:352-683-3994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7878111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL382155200Medicaid
FL382155200Medicaid
FLU87943Medicare UPIN