is a Surgery in Sullivan, Missouri. practices all healthcare services and medical treatments related to Surgery. The NPI Number for is 1093826950. The last update date is .
's current location address is 965 Mattox Dr, Sullivan, Missouri. You can contact this provider via phone number 5738606000 and fax number 5738606016. The mailing address for is 965 Mattox Dr, Sullivan, Missouri. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 965 Mattox Dr, Sullivan, Missouri |
Phone Number | 5738606000 |
Fax Number | 5738606016 |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1093826950 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 965 Mattox Dr |
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City | Sullivan |
State | Missouri (MO) |
Post Code | 630802365 |
Phone Number | 5738606000 |
Fax Number | 5738606016 |
Provider's Primary Taxonomy Detail
Speciality | Surgery |
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Taxonomy | 208600000X |
Licence No | 114756 |
Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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203776505 | MO | -- |
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