Healthcare Provider Details

I. General information

NPI: 1679510358
Provider Name (Legal Business Name): RONDA D. AZELTON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E HIGHWAY 60
MONETT MO
65708-8258
US

IV. Provider business mailing address

3801 S NATIONAL AVE
SPRINGFIELD MO
65807-5210
US

V. Phone/Fax

Practice location:
  • Phone: 417-354-1400
  • Fax: 417-354-1412
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2010026539
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: