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:
Health care specialties
Specialty | Code | License # | 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 9 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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