Crist, Roderic Clayton
Crist, Roderic Clayton is an sole proprietor health care provider with primary practice located at 3095 Lexington Ave Suite 200, Cape Girardeau MO 63701-2602. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Crist, Roderic Clayton can be contacted via phone (573) 339-0004.Contact Information
Primary practice address
3095 Lexington Ave Suite 200
Cape Girardeau MO 63701-2602
Phone: (573) 339-0004
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | R2H52 | Missouri |
Profile Details
| NPI number | 1033180120 |
|---|---|
| LBN Legal business name | Crist, Roderic Clayton |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 28th, 2006 |
| Last updated | Aug 11th, 2011 - about 14 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 | 1033180120 | NPPES |
| Missouri | Other | 820571426 | TRICARE |
| Missouri | Other | 080192016 | TRICARE |
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