Provider Demographics
NPI:1902934896
Name:RUMP, ANTHONY G (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:G
Last Name:RUMP
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 1:1502 N PERRY ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:OH
Mailing Address - Zip Code:45875-1167
Mailing Address - Country:US
Mailing Address - Phone:419-523-4898
Mailing Address - Fax:419-523-4979
Practice Address - Street 1:1502 N PERRY ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:OH
Practice Address - Zip Code:45875-1167
Practice Address - Country:US
Practice Address - Phone:419-523-4898
Practice Address - Fax:419-523-4979
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH735005OtherBUCKEYE COMMUNITY PROVIDE
OH2389599Medicaid
OH000000136402OtherANTHEM BC-BS PROVIDER#
OH34-1668973-00OtherBWC PROVIDER #
OH0004616716OtherAETNA PROVIDER#
OHU29860Medicare UPIN
OHRU-0687471Medicare ID - Type UnspecifiedMC PROVIDER #