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NPI Code Detail

MEDICARE: DR. LANCE HAMILTON BORUP D.O.

MEDICARE: DR. LANCE HAMILTON BORUP D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician0533791KS
22085R0202XDiagnostic Radiology Physician4587OK
32085R0202XDiagnostic Radiology PhysicianE-8860AR
42085R0202XDiagnostic Radiology Physician2009018431MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356320436
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LANCE HAMILTON BORUP D.O.
Provider Business Mailing Address
First Line : 1202 RUSTIC RDG
Second Line :
City : JOPLIN
State : MO
Zip : 64804-3679
Country : US
Telephone Number : 417-434-2991
Fax Number :
Provider Business Practice Location Address
First Line : 525 BRANSON LANDING BLVD
Second Line :
City : BRANSON
State : MO
Zip : 65616-2052
Country : US
Telephone Number : 417-875-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2006
Last Update Date : 02/02/2023

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Directions to “ DR. LANCE HAMILTON BORUP D.O.” Practice Location

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