Provider Demographics
NPI:1447473806
Name:WITT, RODNEY P (DC)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:P
Last Name:WITT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-0177
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1845 N COMMERCE DR
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-7603
Practice Address - Country:US
Practice Address - Phone:417-725-5553
Practice Address - Fax:417-725-6279
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005774111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO350026770OtherRAILROAD MEDICARE
MO15514OtherBLUECROSS BLUESHIELD
MO350026770OtherRAILROAD MEDICARE