Dale, David W
Dale, David W is an sole proprietor health care provider with primary practice located at 1340 S Sam Houston Blvd , Houston MO 65483-2045. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Rural Health, Ambulatory Health Care Facilities / Clinic/Center. Ambulatory Health Care Facilities / Rural Health is his primary health care specialty. Dale, David W can be contacted via phone (417) 967-3755.Contact Information
Primary practice address
1340 S Sam Houston Blvd
Houston MO 65483-2045
Phone: (417) 967-3755
Fax: (417) 967-2630
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | R3C32 | Missouri |
Ambulatory Health Care Facilities / Rural Health | 261QR1300X | ||
Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X |
Profile Details
NPI number | 1568463925 |
---|---|
LBN Legal business name | Dale, David W |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 9th, 2005 |
Last updated | Aug 14th, 2013 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1568463925 | NPPES |
Missouri | MEDICAID | 242088722 | |
Missouri | MEDICAID | 207623109 | |
Missouri | MEDICAID | 598235703 | |
Missouri | Other | 001013745 | |
Missouri | MEDICAID | 503362600 | |
Missouri | MEDICAID | 593362601 |
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