Preston, Bruce Edward

Preston, Bruce Edward is an individual health care provider with primary practice located at 805 N Kentucky St , West Plains MO 65775-2022. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Preston, Bruce Edward can be contacted via phone (417) 256-2111.

Contact Information

Primary practice address
805 N Kentucky St West Plains MO 65775-2022
Phone: (417) 256-2111
Fax: (417) 256-4858
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X R7937 Missouri

Profile Details

NPI number 1972506533
LBN Legal business name Preston, Bruce Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Jan 23rd, 2008 - about 18 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 1972506533 NPPES
Missouri MEDICAID 599022307
Missouri Other P00207380
Missouri MEDICAID 200952109
Missouri MEDICAID 599022308

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