Delport, Brendon

Delport, Brendon is an individual health care provider with primary practice located at 2828 N National Ave , Springfield MO 65803-4306. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Delport, Brendon can be contacted via phone (417) 837-4003.

Contact Information

Primary practice address
2828 N National Ave Springfield MO 65803-4306
Phone: (417) 837-4003
Fax: (417) 875-4782
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 2004008249 Missouri

Profile Details

NPI number 1194721100
LBN Legal business name Delport, Brendon
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Jun 16th, 2011 - about 13 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 1194721100 NPPES
Missouri MEDICAID 1194721100
Missouri Other P00261949
Missouri MEDICAID 209165604

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