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
Phone: (541) 673-1785
Fax: (541) 345-6315
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter | 237600000X | Oregon | |
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist | 237700000X | HAS-P-824882 | Oregon |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1821128216 | NPPES |
Other | 2432417000 | FEDERAL WORKERS COMP | |
MEDICAID | 212936 | FEDERAL WORKERS COMP |
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