Provider Demographics
NPI:1912004482
Name:HANKS, DOUGLAS J (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:J
Last Name:HANKS
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 1:433 E MOUNT PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WEST BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52655-1324
Mailing Address - Country:US
Mailing Address - Phone:319-753-5441
Mailing Address - Fax:319-753-5442
Practice Address - Street 1:433 E MOUNT PLEASANT ST
Practice Address - Street 2:
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1324
Practice Address - Country:US
Practice Address - Phone:319-753-5441
Practice Address - Fax:319-753-5442
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05646111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0088989Medicaid
IA09196OtherBCBS
IAU35371Medicare UPIN
IAI7268Medicare PIN