Provider Demographics
NPI:1205973096
Name:STEGALL, DARON M (DC)
Entity type:Individual
Prefix:
First Name:DARON
Middle Name:M
Last Name:STEGALL
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:8611 N BLACK CANYON HWY
Mailing Address - Street 2:SUITE 214
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4105
Mailing Address - Country:US
Mailing Address - Phone:602-358-7429
Mailing Address - Fax:602-358-7434
Practice Address - Street 1:101 N 1ST AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-1902
Practice Address - Country:US
Practice Address - Phone:602-358-7429
Practice Address - Fax:602-358-7434
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ7402111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0916770Medicare UPIN