Witzel, Bryon J
Witzel, Bryon J is an individual health care provider with primary practice located at 621 S New Ballas Rd Suite 3005B, Saint Louis MO 63141-8232. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Allopathic & Osteopathic Physicians / Emergency Medicine. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Witzel, Bryon J can be contacted via phone (314) 251-7070.Contact Information
Primary practice address
621 S New Ballas Rd Suite 3005B
Saint Louis MO 63141-8232
Phone: (314) 251-7070
Fax: (314) 251-7071
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 2006034878 | Missouri |
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 085-002185 | Illinois |
Profile Details
NPI number | 1528065844 |
---|---|
LBN Legal business name | Witzel, Bryon J |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 1st, 2005 |
Last updated | Mar 3rd, 2015 - about 9 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 | 1528065844 | NPPES |
Illinois | Other | P00174465 | MEDICARE RAILROAD |
Illinois | Other | P00651238 | MEDICARE RAILROAD |
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