Davis, Carl J

Davis, Carl J is an individual health care provider with primary practice located at 2240 W Sunset St Ste 100 , Springfield MO 65807-6041. He recently has only one registered license in Other Service Providers / Prevention Professional, which is considered as his primary health care specialty. Davis, Carl J can be contacted via phone (417) 269-4663.

Contact Information

Primary practice address
2240 W Sunset St Ste 100 Springfield MO 65807-6041
Phone: (417) 269-4663
Fax: (417) 269-0607
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Prevention Professional 405300000X 100332 Missouri

Profile Details

NPI number 1093475121
LBN Legal business name Davis, Carl J
Credentials Certified Respiratory Therapist (CRT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2021
Last updated Jun 14th, 2023 - about last year

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 1093475121 NPPES
Missouri MEDICAID 350105584

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