Provider Demographics
NPI:1730149675
Name:BETT, DOUGLAS S JR (DC)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:S
Last Name:BETT
Suffix:JR
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 1:3447 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-4919
Mailing Address - Country:US
Mailing Address - Phone:316-942-0119
Mailing Address - Fax:
Practice Address - Street 1:749 N WEST ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-1240
Practice Address - Country:US
Practice Address - Phone:316-942-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS350019932OtherPALMETTO GBA RAILROAD MED
KS055859OtherBLUE SHIELD NUMBER