Healthcare Provider Details

I. General information

NPI: 1912948910
Provider Name (Legal Business Name): CHAD DOUGLAS EFIRD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 03/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 CAHILL RD STE 206
BRANSON MO
65616-2036
US

IV. Provider business mailing address

121 CAHILL RD STE 206
BRANSON MO
65616-2036
US

V. Phone/Fax

Practice location:
  • Phone: 417-348-8100
  • Fax: 417-348-8104
Mailing address:
  • Phone: 417-348-8100
  • Fax: 417-348-8104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number47813
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2007007764
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberE6697
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: