MEDICARE: CENTRAL MISSOURI CARDIOVASCULAR ASSOCIATES, INC.

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
1	208600000X	Surgery Physician	105982	MO

Other Identifiers

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

General Provider Information

NPI Number	:	1568630093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL MISSOURI CARDIOVASCULAR ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	5780 OSAGE BEACH PKWY
Second Line	:	SUITE 200
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065-3188
Country	:	US
Telephone Number	:	573-302-0032
Fax Number	:	573-302-0378

Provider Business Practice Location Address
First Line	:	5780 OSAGE BEACH PKWY
Second Line	:	SUITE 200
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065-3188
Country	:	US
Telephone Number	:	573-302-0032
Fax Number	:	573-302-0378

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. COLIN ERNEST BAILEY
Credential	:	M.D.
Telephone Number	:	573-302-0032

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	09/10/2013

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Directions to “CENTRAL MISSOURI CARDIOVASCULAR ASSOCIATES, INC. ” Practice Location

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