Provider Demographics
NPI:1205047529
Name:ART'S ADVANCED CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:ART'S ADVANCED CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SIXKILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-825-9355
Mailing Address - Street 1:P.O. BOX 128
Mailing Address - Street 2:
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-0128
Mailing Address - Country:US
Mailing Address - Phone:918-825-9355
Mailing Address - Fax:918-825-4773
Practice Address - Street 1:108 SOUTH ADAIR
Practice Address - Street 2:
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361
Practice Address - Country:US
Practice Address - Phone:918-825-9355
Practice Address - Fax:918-825-4773
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ART'S ADVANCED CHIROPRACTIC INC. P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-25
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3464111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========OtherTAX OR GRP NUMBER
OK513704759Medicare UPIN
OK=========OtherTAX OR GRP NUMBER