Provider Demographics
NPI:1205918505
Name:XANTHOS, ROBERT CHRISTOPHER (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHRISTOPHER
Last Name:XANTHOS
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 1:5727 N 7TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5817
Mailing Address - Country:US
Mailing Address - Phone:602-264-4040
Mailing Address - Fax:602-264-3433
Practice Address - Street 1:5727 N 7TH ST STE 300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5817
Practice Address - Country:US
Practice Address - Phone:602-264-4040
Practice Address - Fax:602-264-3433
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDC5470Medicare ID - Type Unspecified
AZU6190Medicare UPIN