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NPI Code Detail

MEDICARE: SAMUEL M TEMESGEN M.D.

MEDICARE: SAMUEL M TEMESGEN M.D.
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
12084P0800XPsychiatry Physician2015003086MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
113709871OTHERCAQH
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972891455
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL M TEMESGEN M.D.
Provider Business Mailing Address
First Line : 2885 W BATTLEFIELD ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-3952
Country : US
Telephone Number : 417-761-5000
Fax Number :
Provider Business Practice Location Address
First Line : 1805 E WALNUT ST
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-6425
Country : US
Telephone Number : 573-777-7524
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2011
Last Update Date : 12/10/2025

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