Provider Demographics
NPI:1013154145
Name:BRINSON, STEVEN (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:BRINSON
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 1:129 E VINCENNES ST
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47441-1859
Mailing Address - Country:US
Mailing Address - Phone:812-847-4330
Mailing Address - Fax:812-847-4073
Practice Address - Street 1:129 E VINCENNES ST
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:IN
Practice Address - Zip Code:47441-1859
Practice Address - Country:US
Practice Address - Phone:812-847-4330
Practice Address - Fax:812-847-4073
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002418A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM400038589OtherMEDICARE PART B PTAN
IN200931650Medicaid
INP00970285OtherRAILROAD MEDICARE PTAN