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Individual
DR. LEE BRENT DOVER
Active
Individual
DR. LEE BRENT DOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
12929
TX
111N00000X
Chiropractor
1507
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154829718
—
AR
01
—
5U484
BCBS
AR
01
—
710830330
FEDERAL ID#
AR
01
—
7511063
AETNA
AR
01
—
P00128953
RAILROAD MEDICARE
AR
Enumeration date
02/27/2006
Last updated
08/18/2015
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