Provider Demographics
NPI:1801864996
Name:SIKKEMA, JOHN D (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:SIKKEMA
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 1:1000 E NORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5348
Mailing Address - Country:US
Mailing Address - Phone:352-787-7499
Mailing Address - Fax:352-787-7461
Practice Address - Street 1:1000 E NORTH BLVD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5348
Practice Address - Country:US
Practice Address - Phone:352-787-7499
Practice Address - Fax:352-787-7461
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6701111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381621400Medicaid
FL381621400Medicaid
FLU19953Medicare UPIN