Derose, Christopher J

Derose, Christopher J is an individual health care provider with primary practice located at 500 Keene St Suite 103, Columbia MO 65201-8104. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Derose, Christopher J can be contacted via phone (573) 874-2030.

Contact Information

Primary practice address
500 Keene St Suite 103 Columbia MO 65201-8104
Phone: (573) 874-2030
Fax: (573) 884-5575
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046009246 Illinois
Eye and Vision Services Providers / Optometrist 152W00000X 2006037577 Missouri

Profile Details

NPI number 1831141753
LBN Legal business name Derose, Christopher J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Apr 10th, 2009 - about 16 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 1831141753 NPPES
Missouri MEDICAID 314025008

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