Declue, John A

Declue, John A is an individual health care provider with primary practice located at 2181 Orange Ave E , Tallahassee FL 32311-6144. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Declue, John A can be contacted via phone (850) 878-0191.

Contact Information

Primary practice address
2181 Orange Ave E Tallahassee FL 32311-6144
Phone: (850) 878-0191
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 037522 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2014010401 Missouri

Profile Details

NPI number 1235104886
LBN Legal business name Declue, John A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Jun 18th, 2024 - 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 1235104886 NPPES
Missouri MEDICAID 1235104886
Missouri Other 124920003
Missouri MEDICAID 00571326F
Missouri Other 480095

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