Provider Demographics
NPI:1649263427
Name:DOPPS, BRIAN JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOHN
Last Name:DOPPS
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 1:1405 N ARGONIA RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:KS
Mailing Address - Zip Code:67106-8016
Mailing Address - Country:US
Mailing Address - Phone:620-478-2878
Mailing Address - Fax:620-478-2360
Practice Address - Street 1:1405 N ARGONIA RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:KS
Practice Address - Zip Code:67106-8016
Practice Address - Country:US
Practice Address - Phone:620-478-2878
Practice Address - Fax:620-478-2360
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04477111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062186Medicare ID - Type UnspecifiedMEDICARE NUMBER