Healthcare Provider Details

I. General information

NPI: 1518993807
Provider Name (Legal Business Name): LESTER E COX MEDICAL CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 11/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 CORTNEY LN
CRANE MO
65633-9192
US

IV. Provider business mailing address

3800 S NATIONAL AVE #540
SPRINGFIELD MO
65807-5209
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-2264
  • Fax: 417-723-5793
Mailing address:
  • Phone: 417-269-5712
  • Fax: 417-269-4869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID P. TAYLOR
Title or Position: VICE PRESIDENT
Credential:
Phone: 417-269-6262