Wytock, Dale H
Wytock, Dale H is an individual health care provider with primary practice located at 2521 Glenn Hendren Dr Ste 408, Liberty MO 64068-3388. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Wytock, Dale H can be contacted via phone (816) 478-4887.Contact Information
Primary practice address
2521 Glenn Hendren Dr Ste 408
Liberty MO 64068-3388
Phone: (816) 478-4887
Fax: (816) 478-7222
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 117459 | Missouri |
Profile Details
| NPI number | 1518960467 |
|---|---|
| LBN Legal business name | Wytock, Dale H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2005 |
| Last updated | Jul 18th, 2008 - about 17 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 | 1518960467 | NPPES |
| Missouri | MEDICAID | 203904404 |
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