Provider Demographics
NPI:1295777803
Name:DOXSEE, WAYNE T (DC)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:T
Last Name:DOXSEE
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 1:7 WALDEN WEST RD
Mailing Address - Street 2:
Mailing Address - City:BERNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19506-8615
Mailing Address - Country:US
Mailing Address - Phone:610-488-7641
Mailing Address - Fax:
Practice Address - Street 1:7 WALDEN WEST RD
Practice Address - Street 2:
Practice Address - City:BERNVILLE
Practice Address - State:PA
Practice Address - Zip Code:19506-8615
Practice Address - Country:US
Practice Address - Phone:610-488-7641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001531L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T29682Medicare UPIN
PA151638Medicare ID - Type Unspecified