Balzer, Larry Dale

Balzer, Larry Dale is an individual health care provider with primary practice located at 105 S Bryant Ave Suite #210, Edmond OK 73034-6399. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Balzer, Larry Dale can be contacted via phone (405) 359-5229.

Contact Information

Primary practice address
105 S Bryant Ave Suite #210 Edmond OK 73034-6399
Phone: (405) 359-5229
Fax: (405) 359-5214
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X E1498 Texas
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X 9795 Oklahoma

Profile Details

NPI number 1235129370
LBN Legal business name Balzer, Larry Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2005
Last updated Dec 21st, 2016 - about 8 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 1235129370 NPPES
Texas Other P00231789 RAIL ROAD RETIREMENT ID
Texas Other 108018103 RAIL ROAD RETIREMENT ID
Texas MEDICAID 115029404 RAIL ROAD RETIREMENT ID
Texas MEDICAID 100116910A RAIL ROAD RETIREMENT ID
Texas Other 4060556 RAIL ROAD RETIREMENT ID

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