Riesenmy, Brandon D.

Riesenmy, Brandon D. is an individual health care provider with primary practice located at 2001 S Connor Ave , Joplin MO 64804-1841. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Riesenmy, Brandon D. can be contacted via phone (417) 782-0880.

Contact Information

Primary practice address
2001 S Connor Ave Joplin MO 64804-1841
Phone: (417) 782-0880
Fax: (417) 782-0884
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 112406 Missouri
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 04-23189 Kansas

Profile Details

NPI number 1083671333
LBN Legal business name Riesenmy, Brandon D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2006
Last updated Feb 7th, 2014 - about 10 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 1083671333 NPPES
Missouri MEDICAID 208649947
Missouri MEDICAID 208649962
Missouri Other 04-23189

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