Fernando, Joseph P
Fernando, Joseph P is an individual health care provider with primary practice located at 2340 Katy Ln Suite 120, Poplar Bluff MO 63901-2300. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Fernando, Joseph P can be contacted via phone (573) 776-7393.Contact Information
Primary practice address
2340 Katy Ln Suite 120
Poplar Bluff MO 63901-2300
Phone: (573) 776-7393
Fax: (573) 776-7396
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 112068 | Missouri |
Profile Details
| NPI number | 1669559605 |
|---|---|
| LBN Legal business name | Fernando, Joseph P |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | May 9th, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669559605 | NPPES |
| Missouri | MEDICAID | 208897603 |
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