Provider Demographics
NPI:1992759989
Name:DESPIRITO, DAVID IX
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DESPIRITO
Suffix:IX
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 1:9148 JOHN SEVIER RD
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:VA
Mailing Address - Zip Code:22844-9501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:134 W COURT ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1409
Practice Address - Country:US
Practice Address - Phone:540-459-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555943111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA235709OtherANTHEM
VA30153OtherSOUTHERN HEALTH
VA30153OtherSOUTHERN HEALTH