MEDICARE: PHILIP STITZER DO

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	207Q00000X	Family Medicine Physician	R7J97	MO

General Provider Information

NPI Number	:	1881693323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP STITZER DO

Provider Business Mailing Address
First Line	:	1501 UNION AVE
Second Line	:
City	:	MOBERLY
State	:	MO
Zip	:	65270-9469
Country	:	US
Telephone Number	:	660-263-4770
Fax Number	:	660-263-2228

Provider Business Practice Location Address
First Line	:	1501 UNION AVE
Second Line	:	SUITE C & D
City	:	MOBERLY
State	:	MO
Zip	:	65270-9469
Country	:	US
Telephone Number	:	660-263-4770
Fax Number	:	660-263-2228

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	04/22/2021

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Directions to “ PHILIP STITZER DO” Practice Location

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