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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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