Provider Demographics
NPI:1922446665
Name:ANDREWS, DOUGLASS EDWIN (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLASS
Middle Name:EDWIN
Last Name:ANDREWS
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 1:6565 TAYLOR MILL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41051-9267
Mailing Address - Country:US
Mailing Address - Phone:859-356-8100
Mailing Address - Fax:
Practice Address - Street 1:6565 TAYLOR MILL RD
Practice Address - Street 2:SUITE B
Practice Address - City:INDEPENDENCE
Practice Address - State:KY
Practice Address - Zip Code:41051-9267
Practice Address - Country:US
Practice Address - Phone:859-356-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4922-12111N00000X
KY5462111N00000X
OH4524111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor