Eitzen Chiropractic PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

3805 Issued in OK

Legal business name

EITZEN CHIROPRACTIC PLLC

Doing business as

Advanced Chiropractic Center

Practice address

523 S Independence St
Enid, OK 73701-5631

Phone

(580) 237-5007

Fax

(580) 234-6851

NPI assigned

Jan 29, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Bradley Eitzen, D.C.NPI 1215026273

Title

Chiropractor

Phone

(580) 237-5007

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advanced Chiropractic Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Bradley Eitzen, D.C.

  • Chiropractor
  • Enid, OK
  • NPI 1215026273
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902942048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 S INDEPENDENCE ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015631",
            "telephone_number": "580-237-5007",
            "fax_number": "580-234-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 S INDEPENDENCE ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737015631",
            "telephone_number": "580-237-5007",
            "fax_number": "580-234-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EITZEN CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EITZEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "580-237-5007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OK",
            "license": "3805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "446902380001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael H Edge
• Kristina Ann Ediger, RPT
• Audrea Edwards
• Sirfreebird Edwards
• Jean Gabriel Egbuna, MD
• John Bradley Eitzen, D.C.
• Colin Hill Eliot, D.D.S.
• Elite RN PC
• Elizabeth a Chaloupek DDS, PC
• Elizabeth Ellis

• Clinic/Center in Enid, OK
• Providers in Enid, OK by specialty
• Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.