Provider Demographics
NPI:1194721829
Name:FLUITT, JEFFREY W (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:W
Last Name:FLUITT
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 5927
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78763-5927
Mailing Address - Country:US
Mailing Address - Phone:512-442-2727
Mailing Address - Fax:512-442-2728
Practice Address - Street 1:6836 BEE CAVES RD STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5059
Practice Address - Country:US
Practice Address - Phone:512-442-2727
Practice Address - Fax:512-442-2728
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U88550Medicare UPIN
TX8F20524Medicare PIN
8001K3Medicare ID - Type Unspecified