Healthcare Provider Details

I. General information

NPI: 1972891455
Provider Name (Legal Business Name): SAMUEL M TEMESGEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 03/21/2026
Certification Date: 03/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 S BUSINESS HIGHWAY 13 STE A
LEXINGTON MO
64067-1572
US

IV. Provider business mailing address

2885 W BATTLEFIELD ST
SPRINGFIELD MO
65807-3952
US

V. Phone/Fax

Practice location:
  • Phone: 877-344-3572
  • Fax: 866-228-4492
Mailing address:
  • Phone: 417-761-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2015003086
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: