Brent, Lanny Ross

Brent, Lanny Ross is an individual health care provider with primary practice located at 3801 S National Ave , Springfield MO 65807-5210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Brent, Lanny Ross can be contacted via phone (417) 269-4056.

Contact Information

Primary practice address
3801 S National Ave Springfield MO 65807-5210
Phone: (417) 269-4056
Fax: (417) 269-5556
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X R4579 Missouri

Profile Details

NPI number 1922067743
LBN Legal business name Brent, Lanny Ross
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated Sep 4th, 2009 - about 15 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 1922067743 NPPES
Missouri Other 1256 BLUE
Missouri Other 300043406 BLUE
Missouri MEDICAID 156871001 BLUE
Missouri MEDICAID 200479806 BLUE

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