Bantle, John A

Bantle, John A is an individual health care provider with primary practice located at 10519 Brightstone Dr , Midlothian VA 23112-1570. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Bantle, John A can be contacted via phone (816) 807-8333.

Contact Information

Primary practice address
10519 Brightstone Dr Midlothian VA 23112-1570
Phone: (816) 807-8333
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 0101240013 Virginia

Profile Details

NPI number 1962447532
LBN Legal business name Bantle, John A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2006
Last updated Jan 12th, 2011 - about 15 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 1962447532 NPPES
Virginia MEDICAID 010314453
Virginia Other 204990
Virginia MEDICAID 010290881
Virginia MEDICAID 010291020
Virginia MEDICAID 1962447532

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