Provider Demographics
NPI:1770547762
Name:CARRAWAY, SIMON WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:SIMON
Middle Name:WILLIAM
Last Name:CARRAWAY
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:PO BOX 220213
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99522-0213
Mailing Address - Country:US
Mailing Address - Phone:907-563-4111
Mailing Address - Fax:907-563-4113
Practice Address - Street 1:5121 ARCTIC BLVD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-7051
Practice Address - Country:US
Practice Address - Phone:907-563-4111
Practice Address - Fax:907-563-4113
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK114111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor