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Contact Information

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

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JONATHON FALLIS DPM LLC

NPI # 1154341592
LBN Legal business name JONATHON FALLIS DPM LLC
Authorized official JONATHON FALLIS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/20/2006
Last updated 04/20/2008 - About 18 years ago
Identifiers
IL License # 016004851
MO License # 2002006341
MO Other 154392 BCBS
MO Other 5502300001 MEDICARE DMERC
MO Other P0038451 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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