Healthcare Provider Details

I. General information

NPI: 1255315289
Provider Name (Legal Business Name): THEODORE H RIGHTS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 12/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 N DAVIS ST
HAMILTON MO
64644-1143
US

IV. Provider business mailing address

1600 E EVERGREEN ST PO BOX 557
CAMERON MO
64429-2400
US

V. Phone/Fax

Practice location:
  • Phone: 816-583-7839
  • Fax: 816-583-7842
Mailing address:
  • Phone: 816-632-2101
  • Fax: 816-649-3383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number106787
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: