MEDICARE: DR. DAVID K. BACKUS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	7534	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AZ0443530	OTHER	AZ	BCBS

General Provider Information

NPI Number	:	1023016425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID K. BACKUS D.C.

Provider Business Mailing Address
First Line	:	13576 W CAMINO DEL SOL STE 23
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-4428
Country	:	US
Telephone Number	:	623-544-0200
Fax Number	:	623-466-0624

Provider Business Practice Location Address
First Line	:	13576 W CAMINO DEL SOL STE 23
Second Line	:
City	:	SUN CITY WEST
State	:	AZ
Zip	:	85375-4428
Country	:	US
Telephone Number	:	623-544-0200
Fax Number	:	623-466-0624

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	10/25/2007

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