Dandridge, Walter C
Dandridge, Walter C is an individual health care provider with primary practice located at 100 Mercy Way Ste 440, Joplin MO 64804-4524. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Dandridge, Walter C can be contacted via phone (417) 781-4404.Contact Information
Primary practice address
100 Mercy Way Ste 440
Joplin MO 64804-4524
Phone: (417) 781-4404
Fax: (417) 781-5845
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | R6557 | Missouri |
Profile Details
| NPI number | 1316985815 |
|---|---|
| LBN Legal business name | Dandridge, Walter C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 4th, 2006 |
| Last updated | Mar 17th, 2016 - about 8 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 | 1316985815 | NPPES |
| Oklahoma | MEDICAID | 100099510A | |
| Oklahoma | MEDICAID | 1316985815 | |
| Oklahoma | Other | P00800462 | |
| Oklahoma | MEDICAID | 100167010E |
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