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State Of Missouri
General Practice Physician in Marshall, Missouri
NPI 1336193895

State Of Missouri is a General Practice Physician based in Jefferson City, MO. State Of Missouri practices in Marshall, MO. The NPI Number for State Of Missouri is 1336193895 and holds a License No. (Missouri).

The current practice location address for State Of Missouri is 1547 W. Commerce Dr, Marshall, MO and can be reached out via phone at 660-886-2201 and via fax at 660-831-3071.

Location: 1547 W. Commerce Dr, Marshall, MO, 65101-4130
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1336193895
Provider Name
State Of Missouri
Credential
Provider Entity Type
Organization
Address
1547 W. Commerce Dr, Marshall, MO, 65101-4130
Phone Number
660-886-2201
Fax Number
660-831-3071
Provider Enumeration Date
05/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
501499800 05 MO
institution
Provider Business Practice Location Address Details
Address
1547 W. Commerce Dr
City
Marshall
State
Missouri
Zip
65340-1240
Phone Number
660-886-2201
Fax Number
660-831-3071
person
Provider Business Mailing Address Details
Address
1547 W. Commerce Dr
City
Marshall
State
Missouri
Zip
65340-1240
Phone Number
660-886-2201
Fax Number
660-831-3071
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
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