Bruggeman, Jerry Joseph

Bruggeman, Jerry Joseph is an individual health care provider with primary practice located at 910 N College Ave Ste 4 , Columbia MO 65201-4797. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bruggeman, Jerry Joseph can be contacted via phone (636) 642-1215.

Contact Information

Primary practice address
910 N College Ave Ste 4 Columbia MO 65201-4797
Phone: (636) 642-1215
Fax: (573) 234-4799
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2004011867 Missouri

Profile Details

NPI number 1033161120
LBN Legal business name Bruggeman, Jerry Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Dec 20th, 2023 - about 2 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 1033161120 NPPES
Missouri MEDICAID 207251901

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