Provider Demographics
NPI:1992787816
Name:NEUFANG, ERIC J (DC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:J
Last Name:NEUFANG
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 1:9735 N 90TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5067
Mailing Address - Country:US
Mailing Address - Phone:602-953-9500
Mailing Address - Fax:602-953-9500
Practice Address - Street 1:9735 N 90TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5067
Practice Address - Country:US
Practice Address - Phone:602-953-9500
Practice Address - Fax:602-953-9500
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU68945Medicare UPIN
AZZ80782Medicare PIN