Provider Demographics
NPI:1922013374
Name:FRED SCHOFIELD PC
Entity Type:Organization
Organization Name:FRED SCHOFIELD PC
Other - Org Name:ATLAS CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHOFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-938-8868
Mailing Address - Street 1:4131 W THUNDERBIRD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85053-5341
Mailing Address - Country:US
Mailing Address - Phone:602-938-8868
Mailing Address - Fax:602-938-5084
Practice Address - Street 1:4131 W THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85053-5341
Practice Address - Country:US
Practice Address - Phone:602-938-8868
Practice Address - Fax:602-938-5084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3713111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0935640OtherBLUE CROSS/BLUE SHIELD
AZZ0000BGLGVMedicare PIN
AZV03943Medicare UPIN