Healthcare Provider Details

I. General information

NPI: 1669854097
Provider Name (Legal Business Name): SYDNEI TOLEFREE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2015
Last Update Date: 12/31/2021
Certification Date: 12/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR MCHANEY HALL 404
COLUMBIA MO
65212-1000
US

IV. Provider business mailing address

PO BOX 801143
KANSAS CITY MO
64180-1143
US

V. Phone/Fax

Practice location:
  • Phone: 573-884-2000
  • Fax:
Mailing address:
  • Phone: 573-331-5583
  • Fax: 573-331-5079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2021048824
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: