Individual
ROGER DEAN FALTYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2620 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3396
(573) 727-2295
Mailing address
3319 FOXWOOD CT, POPLAR BLUFF, MO 63901-9697
(573) 778-9924
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2005006645
MO
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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