Provider Demographics
NPI:1063426583
Name:DEAL, SHELDON C
Entity type:Individual
Prefix:
First Name:SHELDON
Middle Name:C
Last Name:DEAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 N SWAN RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1215
Mailing Address - Country:US
Mailing Address - Phone:520-323-7133
Mailing Address - Fax:520-323-8252
Practice Address - Street 1:1001 N SWAN RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1215
Practice Address - Country:US
Practice Address - Phone:520-323-7133
Practice Address - Fax:520-323-8252
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ567111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
350627466OtherMEDICARE RAILROAD
AZAZ0080910OtherBCBS AZ
T41542Medicare UPIN