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NPI Code Detail

MEDICARE: DAVID W DALE

MEDICARE: DAVID W DALE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2261QR1300XRural Health Clinic/Center

General Provider Information

NPI Number : 1528199494
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID W DALE
Provider Business Mailing Address
First Line : 1340 S SAM HOUSTON BLVD
Second Line :
City : HOUSTON
State : MO
Zip : 65483-2045
Country : US
Telephone Number : 417-967-3755
Fax Number : 417-967-3630
Provider Business Practice Location Address
First Line : 1340 S SAM HOUSTON BLVD
Second Line :
City : HOUSTON
State : MO
Zip : 65483-2045
Country : US
Telephone Number : 417-967-3755
Fax Number : 417-967-3630
Authorized Official
Title or Position : OWNER
Name : DR. DAVID W DALE
Credential : D.O.
Telephone Number : 417-967-3755
Provider Enumeration Date : 03/09/2007
Last Update Date : 06/16/2008

Similar Medicare Providers

1568463925 — DAVID W DALE D.O.
Practice Location Address:
1340 S SAM HOUSTON BLVD
HOUSTON, MO
65483-2045
Practice Phone: 417-967-3755
Practice Fax: 417-967-2630
1902892847 — GLEN C MARSEY LCSW
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1245285139 — MRS. CHARLENE B FURR FNP
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1184899916 — DALE FAMILY MEDICINE
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1326585761 — DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.
Practice Location Address:
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Practice Fax:
1801462551 — MELISSA DAWN CRAWFORD
Practice Location Address:
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Directions to “DAVID W DALE ” Practice Location

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