Provider Demographics
NPI:1700937844
Name:CESARZ, HANS J (DC)
Entity Type:Individual
Prefix:DR
First Name:HANS
Middle Name:J
Last Name:CESARZ
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 1:502 RIVER RIDGE CENTER
Mailing Address - Street 2:
Mailing Address - City:BRANDENBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40108-1702
Mailing Address - Country:US
Mailing Address - Phone:270-422-4445
Mailing Address - Fax:270-422-4927
Practice Address - Street 1:502 RIVER RIDGE CENTER
Practice Address - Street 2:
Practice Address - City:BRANDENBURG
Practice Address - State:KY
Practice Address - Zip Code:40108-1702
Practice Address - Country:US
Practice Address - Phone:270-422-4445
Practice Address - Fax:270-422-4927
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85001386Medicaid
6055501Medicare ID - Type Unspecified
KY85001386Medicaid