Healthcare Provider Details

I. General information

NPI: 1154368413
Provider Name (Legal Business Name): JOSEPH E QUARANTO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 BUTLER ST
MACON MO
63552-1629
US

IV. Provider business mailing address

1513 UNION AVE STE 1700
MOBERLY MO
65270-9407
US

V. Phone/Fax

Practice location:
  • Phone: 660-385-3118
  • Fax: 660-385-4271
Mailing address:
  • Phone: 660-269-2926
  • Fax: 660-269-2943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO32287
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: