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Mr. Baron K Short
Customized Equipment (DME) in O Fallon, Illinois
NPI 1811220577

Baron K Short is a Customized Equipment (DME) based in O Fallon, IL and is specialized in Customized Equipment. Baron K Short practices in O Fallon, IL. The NPI Number for Baron K Short is 1811220577 and holds a License No. 3949-4810 (Illinois).

The current practice location address for Baron K Short is 729 W Us Highway 50, O Fallon, IL and can be reached out via phone at 618-447-3392.

Location: 729 W Us Highway 50, O Fallon, IL, 62269-1972
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811220577
Provider Name
Baron K Short
Credential
Provider Entity Type
Individual
Gender
Male
Address
729 W Us Highway 50, O Fallon, IL, 62269-1972
Phone Number
618-447-3392
Fax Number
Provider Enumeration Date
09/14/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
729 W Us Highway 50
City
O Fallon
State
Illinois
Zip
62269-1972
Phone Number
618-447-3392
Fax Number
person
Provider Business Mailing Address Details
Address
729 W Us Highway 50
City
O Fallon
State
Illinois
Zip
62269-1972
Phone Number
618-447-3392
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
332BC3200X
License No.
3949-4810 (Illinois)
Definition
Definition to come...
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