Provider Demographics
NPI:1720188733
Name:SHOCHAT, WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:
Last Name:SHOCHAT
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 1:5620 N BARRASCA AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1328
Mailing Address - Country:US
Mailing Address - Phone:520-299-0100
Mailing Address - Fax:520-615-0778
Practice Address - Street 1:5620 N BARRASCA AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-1328
Practice Address - Country:US
Practice Address - Phone:520-299-0100
Practice Address - Fax:520-615-0778
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ78778Medicare ID - Type Unspecified