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Contact Information

JONATHON L FALLIS, DPM
1513 UNION AVE
SUITE 1400
MOBERLY, MO65270
 Phone: 660-263-6677
 Fax: 660-263-6688
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JONATHON L FALLIS · (Male)

NPI Number 1659391084
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 07/20/2006
Last updated 10/19/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 2002006341
  • IL Medicaid 061748265652701
  • MO Medicaid 305751208
  • IL Other P00242773 RAILROAD MEDICARE
  • MO Other 154392 BLUE CROSS/BLUE SHEILD
  • MO Other 5502300001 DMERC
  • MO Other P00241817 RAILROAD MEDICARE
  • MO Other P00242773 RAILROAD MEDICARE
Hospital affiliation(s)
  • FITZGIBBON MEMORIAL HOSPITAL - (Acute Care)
    2305 S 65 HIGHWAY
    MARSHALL, MO 65340
  • MOBERLY REGIONAL MEDICAL CENTER - (Acute Care)
    1515 UNION AVE
    MOBERLY, MO 65270
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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