Healthcare Provider Details

I. General information

NPI: 1356343826
Provider Name (Legal Business Name): JOSEPH CHESTER FRANCIS CAMIRE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17959 MAIN STREET
EMINENCE MO
65466
US

IV. Provider business mailing address

110 S 2ND ST
ELLINGTON MO
63638-9400
US

V. Phone/Fax

Practice location:
  • Phone: 573-226-5505
  • Fax: 573-226-5584
Mailing address:
  • Phone: 573-663-2313
  • Fax: 573-663-2441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number112624
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: