Byergo, Bradley Alan

Byergo, Bradley Alan is an individual health care provider with primary practice located at 1384 S 5Th St , Saint Charles MO 63301-2444. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Byergo, Bradley Alan can be contacted via phone (636) 946-9242.

Contact Information

Primary practice address
1384 S 5Th St Saint Charles MO 63301-2444
Phone: (636) 946-9242
Fax: (636) 946-4903
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2002015240 Missouri

Profile Details

NPI number 1336272285
LBN Legal business name Byergo, Bradley Alan
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 13th, 2007
Last updated Jun 29th, 2022 - about 4 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 1336272285 NPPES
Missouri MEDICAID 315859009

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