Provider Demographics
NPI:1861555021
Name:SCHEETZ, BRIAN P (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:P
Last Name:SCHEETZ
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 1:7634 SLATE RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-8159
Mailing Address - Country:US
Mailing Address - Phone:614-367-1203
Mailing Address - Fax:614-367-1204
Practice Address - Street 1:7634 SLATE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-8159
Practice Address - Country:US
Practice Address - Phone:614-367-1203
Practice Address - Fax:614-367-1204
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3331111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000355650OtherANTHEM BLUE CROSS BLUE SH
OH20114755900OtherMANAGED MEDICAL INSURANCE
OH7109596OtherAETNA
OH61129230OtherOWCP
OH0000227811403OtherUNITED HEALTHCARE INSURAN
OH0239512Medicaid
OH11323783OtherCAQH
OH645548OtherACN
OH7109596OtherAETNA
U95839Medicare UPIN
OH0239512Medicaid