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NPI Code Detail

MEDICARE: THARRON ROY

MEDICARE: THARRON ROY
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
1390200000XStudent in an Organized Health Care Education/Training ProgramMO

General Provider Information

NPI Number : 1558209056
Entity Type Code : Individual
Provider Name (Legal Business Name) : THARRON ROY
Provider Business Mailing Address
First Line : 3800 S NATIONAL AVE STE 700
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-5279
Country : US
Telephone Number : 417-269-8817
Fax Number : 417-269-8744
Provider Business Practice Location Address
First Line : 3800 S NATIONAL AVE STE 700
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-5279
Country : US
Telephone Number : 417-269-8817
Fax Number : 417-269-8744
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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Directions to “ THARRON ROY ” Practice Location

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