Dorris, Jerry W

Dorris, Jerry W is an individual health care provider with primary practice located at 118 W Dallas St , Buffalo MO 65622-8669. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Dorris, Jerry W can be contacted via phone (417) 345-6101.

Contact Information

Primary practice address
118 W Dallas St Buffalo MO 65622-8669
Phone: (417) 345-6101
Fax: (417) 829-4316
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 148324 Missouri

Profile Details

NPI number 1386744811
LBN Legal business name Dorris, Jerry W
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 24th, 2006
Last updated Oct 27th, 2021 - about 3 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 1386744811 NPPES
Missouri MEDICAID 421151309

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