MEDICARE: RICHARD O. FOLLWELL, P.C.

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

General Provider Information

NPI Number	:	1679560015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD O. FOLLWELL, P.C.

Provider Business Mailing Address
First Line	:	600 MEDICAL DR
Second Line	:	SUITE 202
City	:	WENTZVILLE
State	:	MO
Zip	:	63385-3426
Country	:	US
Telephone Number	:	636-332-6606
Fax Number	:	636-639-5048

Provider Business Practice Location Address
First Line	:	600 MEDICAL DR
Second Line	:	SUITE 202
City	:	WENTZVILLE
State	:	MO
Zip	:	63385-3426
Country	:	US
Telephone Number	:	636-332-6606
Fax Number	:	636-639-5048

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DONNA JEAN LAPOINTE
Credential	:
Telephone Number	:	636-332-6606

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	10/02/2007

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