Healthcare Provider Details

I. General information

NPI: 1447498878
Provider Name (Legal Business Name): EMELINDA V TOLOD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMELINDA G. TOLOD M.D.

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 THE HAMPTONS LN
CHESTERFIELD MO
63017-5901
US

IV. Provider business mailing address

2620 N WESTWOOD BLVD
POPLAR BLUFF MO
63901-3396
US

V. Phone/Fax

Practice location:
  • Phone: 314-878-2587
  • Fax:
Mailing address:
  • Phone: 573-776-2000
  • Fax: 573-776-2790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR5917
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: