Provider Demographics
NPI:1598899817
Name:VAN TASSEL, DONALD JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JOHN
Last Name:VAN TASSEL
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 1:2309 WEDNESDAY ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4335
Mailing Address - Country:US
Mailing Address - Phone:850-385-5113
Mailing Address - Fax:850-385-5601
Practice Address - Street 1:2309 WEDNESDAY ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4335
Practice Address - Country:US
Practice Address - Phone:850-385-5113
Practice Address - Fax:850-385-5601
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22660OtherBLUE CROSS BLUE SHIELD FL
LA3111FOtherBCBS LA
GA20444443OtherBCBS GA
FL22660Medicare ID - Type Unspecified
GA20444443OtherBCBS GA