Brockett, David W

Brockett, David W is an individual health care provider with primary practice located at 3000 Nw Stewart Pkwy , Roseburg OR 97471-1655. He recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter, Speech, Language and Hearing Service Providers / Hearing Instrument Specialist. Speech, Language and Hearing Service Providers / Hearing Instrument Specialist is his primary health care specialty. Brockett, David W can be contacted via phone (541) 673-1785.

Contact Information

Primary practice address
3000 Nw Stewart Pkwy Roseburg OR 97471-1655
Fax: (541) 345-6315
Website:

Profile Details

NPI number 1821128216
LBN Legal business name Brockett, David W
Credentials BC-HIS
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2007
Last updated Jan 29th, 2018 - about 6 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 1821128216 NPPES
Other 2432417000 FEDERAL WORKERS COMP
MEDICAID 212936 FEDERAL WORKERS COMP

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