Chism, William R

Chism, William R is an individual health care provider with primary practice located at 1000 W Jackson St , Ozark MO 65721-9163. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Chism, William R can be contacted via phone (417) 581-5581.

Contact Information

Primary practice address
1000 W Jackson St Ozark MO 65721-9163
Phone: (417) 581-5581
Fax: (417) 581-5511
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X TO2288 Missouri

Profile Details

NPI number 1639240955
LBN Legal business name Chism, William R
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2006
Last updated Apr 30th, 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 1639240955 NPPES
Missouri Other 4917230002 DMERC REGION D
Missouri MEDICAID 310415237 DMERC REGION D
Missouri MEDICAID 310415245 DMERC REGION D

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