Melton, Derek Joseph
Melton, Derek Joseph is an sole proprietor health care provider with primary practice located at 4061 Hwy Pp Suite 1 Melton Eye Care Associates, Poplar Bluff MO 63901. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Melton, Derek Joseph can be contacted via phone (573) 778-9143.Contact Information
Primary practice address
4061 Hwy Pp Suite 1 Melton Eye Care Associates
Poplar Bluff MO 63901
Phone: (573) 778-9143
Fax: (573) 778-9164
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 2004006937 | Missouri |
| Eye and Vision Services Providers / Optometrist | 152W00000X | MO2004006937 | Missouri |
Profile Details
| NPI number | 1922058429 |
|---|---|
| LBN Legal business name | Melton, Derek Joseph |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 12th, 2006 |
| Last updated | Feb 15th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922058429 | NPPES |
| Missouri | MEDICAID | 317617207 |
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