MEDICARE: DR. DANIEL PAUL BUKOFCHAN 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	111NS0005X	Sports Physician Chiropractor	08001533	IN
2	111NX0800X	Orthopedic Chiropractor	08001533	IN

General Provider Information

NPI Number	:	1134124290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL PAUL BUKOFCHAN D.C.

Provider Business Mailing Address
First Line	:	PO BOX 387
Second Line	:
City	:	BROOKVILLE
State	:	IN
Zip	:	47012-0387
Country	:	US
Telephone Number	:	765-647-0249
Fax Number	:

Provider Business Practice Location Address
First Line	:	1235 FRANKLIN AVE
Second Line	:
City	:	BROOKVILLE
State	:	IN
Zip	:	47012-1037
Country	:	US
Telephone Number	:	765-647-5332
Fax Number	:	765-647-6300

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	09/11/2025

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