Bomar, Sally A.

Bomar, Sally A. is an individual health care provider with primary practice located at 2016 S Main St , Maryville MO 64468-2655. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bomar, Sally A. can be contacted via phone (660) 562-2525.

Contact Information

Primary practice address
2016 S Main St Maryville MO 64468-2655
Phone: (660) 562-2525
Fax: (660) 562-4303
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 105981 Missouri
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 31578 Iowa

Profile Details

NPI number 1043212228
LBN Legal business name Bomar, Sally A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Nov 9th, 2012 - about 12 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 1043212228 NPPES
Iowa MEDICAID 0984591
Iowa MEDICAID 208078311

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