Organization · Type 2 NPI
State of Missouri
General Practice Physician · Nevada, MO
NPI number
1114971702
Active
Practice location
2323 N Ash St
Nevada, MO 64772-1054
Fax (417) 448-1138
Mailing address
1706 E Elm St
Jefferson City, MO 65101-4130
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry Physician | 2084P0800X | None listed |
| General Practice Physician Primary | 208D00000X | None listed |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
4 other providers at this address
- State of MissouriIntellectual Disabilities Intermediate Care Facility Nevada, MO NPI 1376614701
- State of MissouriIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Nevada, MO NPI 1811137516
- Inn T. Park, MDIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Nevada, MO NPI 1588713853
- Lewis Shilane, DOFamily Medicine Physician Nevada, MO NPI 1013940469
Other general practice physician providers in Nevada
About NPI 1114971702
State of Missouri's National Provider Identifier is 1114971702, issued on May 19, 2006. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Nevada, MO. The record was last updated on Aug 26, 2020.