Provider Demographics
NPI:1750451126
Name:HEMPHILL, VITO (DC)
Entity Type:Individual
Prefix:DR
First Name:VITO
Middle Name:
Last Name:HEMPHILL
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 1:435 SAINT MICHAELS DR
Mailing Address - Street 2:SUITE B-204
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7672
Mailing Address - Country:US
Mailing Address - Phone:505-982-6665
Mailing Address - Fax:505-983-1679
Practice Address - Street 1:435 SAINT MICHAELS DR
Practice Address - Street 2:SUITE B-204
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7672
Practice Address - Country:US
Practice Address - Phone:505-982-6665
Practice Address - Fax:505-983-1679
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMK229Medicare UPIN
NM2670498Medicare ID - Type Unspecified