Ayres, Bruce Wallace

Ayres, Bruce Wallace is an sole proprietor health care provider with primary practice located at 705 Gage Blvd Suite 100, Richland WA 99352-9716. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Ayres, Bruce Wallace can be contacted via phone (509) 374-4400.

Contact Information

Primary practice address
705 Gage Blvd Suite 100 Richland WA 99352-9716
Phone: (509) 374-4400
Fax: (509) 374-4440
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD00043560 Washington

Profile Details

NPI number 1962419473
LBN Legal business name Ayres, Bruce Wallace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 1st, 2006
Last updated Oct 6th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962419473 NPPES
Washington MEDICAID 1120526

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