Rose, Douglas G
Rose, Douglas G is an individual health care provider with primary practice located at 390 Mid Rivers Mall Dr Suite 290, Saint Peters MO 63376-1565. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Rose, Douglas G can be contacted via phone (636) 279-2020.Contact Information
Primary practice address
390 Mid Rivers Mall Dr Suite 290
Saint Peters MO 63376-1565
Phone: (636) 279-2020
Fax: (636) 279-1055
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2002016606 | Missouri |
Profile Details
| NPI number | 1285654418 |
|---|---|
| LBN Legal business name | Rose, Douglas G |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 20th, 2006 |
| Last updated | Nov 18th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285654418 | NPPES |
| Missouri | MEDICAID | 1285654418 |
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