Broyles, Damon R.

Broyles, Damon R. is an individual health care provider with primary practice located at 701 S New Ballas Rd Ste 150 , Saint Louis MO 63141-8728. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Broyles, Damon R. can be contacted via phone (636) 237-4025.

Contact Information

Primary practice address
701 S New Ballas Rd Ste 150 Saint Louis MO 63141-8728
Phone: (636) 237-4025
Fax: (636) 237-4030
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2004002145 Missouri

Profile Details

NPI number 1407856396
LBN Legal business name Broyles, Damon R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Aug 20th, 2024 - about 2 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 1407856396 NPPES
Missouri MEDICAID 208987800

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