Provider Demographics
NPI:1982683991
Name:CHIAFFITELLI, MICHAEL A (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:CHIAFFITELLI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:A
Other - Last Name:CHIAFFITELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:10001 S PENNSYLVANIA AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6938
Mailing Address - Country:US
Mailing Address - Phone:405-681-2273
Mailing Address - Fax:405-681-2274
Practice Address - Street 1:10001 S PENN BLDG P STE.170
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6938
Practice Address - Country:US
Practice Address - Phone:405-681-2273
Practice Address - Fax:405-681-2274
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKDC2616111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U25292Medicare UPIN