Provider Demographics
NPI:1720127251
Name:SAXON, FORREST WAYNE (DC)
Entity Type:Individual
Prefix:
First Name:FORREST
Middle Name:WAYNE
Last Name:SAXON
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 1:105 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ULYSSES
Mailing Address - State:KS
Mailing Address - Zip Code:67880-2519
Mailing Address - Country:US
Mailing Address - Phone:620-356-5505
Mailing Address - Fax:
Practice Address - Street 1:117 E KANSAS AVE
Practice Address - Street 2:
Practice Address - City:ULYSSES
Practice Address - State:KS
Practice Address - Zip Code:67880-2125
Practice Address - Country:US
Practice Address - Phone:620-424-5083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor