Individual provider · Type 1 NPI

Cysco Allen Merisotes

Surgical Physician Assistant · Springfield, MO

NPI number 1073319232 Active

Practice location

2115 S Fremont Ave Ste 5000
Springfield, MO 65804-2230

Mailing address

46 W Cherry St
Fair Grove, MO 65648-8433

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X2025000589 (MO)

Surgical Physician Assistant: Definition to come...

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About NPI 1073319232

Cysco Allen Merisotes's National Provider Identifier is 1073319232, issued on Feb 19, 2025. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Springfield, MO. The record was last updated on Feb 19, 2025.