Provider Demographics
NPI:1770631491
Name:SCHOFIELD, JOHN DEREK (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DEREK
Last Name:SCHOFIELD
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 1:1001 HUDSON ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-2304
Mailing Address - Country:US
Mailing Address - Phone:319-277-5616
Mailing Address - Fax:319-277-0355
Practice Address - Street 1:1001 HUDSON ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2304
Practice Address - Country:US
Practice Address - Phone:319-277-5616
Practice Address - Fax:319-277-0355
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1116269Medicaid
IA16423OtherMIDLANDS CHOICE
IA17094OtherBLUE CROSS BLUE SHIELD
IA16423OtherMIDLANDS CHOICE
IAI14655Medicare ID - Type Unspecified