Healthcare Provider Details

I. General information

NPI: 1821093287
Provider Name (Legal Business Name): DAVID LEE CATHCART M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 07/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

948 E US HIGHWAY 54
CAMDENTON MO
65020-6834
US

IV. Provider business mailing address

PO BOX 777 304 W. WASHINGTON AVENUE
RICHLAND MO
65556-0777
US

V. Phone/Fax

Practice location:
  • Phone: 573-346-4446
  • Fax: 573-346-7501
Mailing address:
  • Phone: 573-765-5131
  • Fax: 573-765-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number109547
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: