Healthcare Provider Details

I. General information

NPI: 1568522324
Provider Name (Legal Business Name): CHIROPRACTIC DOCTORS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6717 S YALE AVE SUITE 110
TULSA OK
74136-3311
US

IV. Provider business mailing address

6717 S YALE AVE SUITE 110
TULSA OK
74136-3311
US

V. Phone/Fax

Practice location:
  • Phone: 918-492-0087
  • Fax: 918-496-0952
Mailing address:
  • Phone: 918-492-0087
  • Fax: 918-496-0952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number1806
License Number StateOK

VIII. Authorized Official

Name: DR. BRAD M. HAYES
Title or Position: PRESIDENT
Credential: DC
Phone: 918-492-0087