Healthcare Provider Details

I. General information

NPI: 1144256462
Provider Name (Legal Business Name): LESTER E COX MEDICAL CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 03/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 COMMERCE DR
AURORA MO
65605-6260
US

IV. Provider business mailing address

3800 S NATIONAL AVE STE. 540
SPRINGFIELD MO
65807-5209
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-2400
  • Fax: 417-269-2410
Mailing address:
  • Phone: 417-269-5712
  • Fax: 417-269-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MAX BUETOW
Title or Position: SR. VICE-PRESIDENT & CFO
Credential:
Phone: 417-631-0381