Provider Demographics
NPI:1164507067
Name:DUKART, ROSANNE MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:ROSANNE
Middle Name:MARIE
Last Name:DUKART
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4626 E FORT LOWELL RD
Mailing Address - Street 2:STE D
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1127
Mailing Address - Country:US
Mailing Address - Phone:520-818-3843
Mailing Address - Fax:
Practice Address - Street 1:4626 E FORT LOWELL RD
Practice Address - Street 2:SUITE N
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1184
Practice Address - Country:US
Practice Address - Phone:520-323-0466
Practice Address - Fax:520-323-6466
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5869111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ5869OtherLANDMARK PROVIDER ID
AZ650634OtherACN PROVIDER ID
AZRD1024962OtherASHN PROVIDER NUMBER
AZAZ0247360OtherBC/BS OF AZ
AZAZ5869OtherLANDMARK PROVIDER ID