Healthcare Provider Details

I. General information

NPI: 1336686724
Provider Name (Legal Business Name): PHILIP S SENG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HIGHLANDER POINT DR SUITE 206
FLOYDS KNOBS IN
47119-9465
US

IV. Provider business mailing address

800 HIGHLANDER POINT DR SUITE 206
FLOYDS KNOBS IN
47119-9465
US

V. Phone/Fax

Practice location:
  • Phone: 812-923-7648
  • Fax: 812-923-3708
Mailing address:
  • Phone: 812-923-7648
  • Fax: 812-923-3708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08001206A
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier100116480A
Identifier TypeMEDICAID
Identifier StateIN
Identifier Issuer

VIII. Authorized Official

Name: DR. PHILIP STUART SENG
Title or Position: OWNER
Credential: DC
Phone: 812-923-7648