Healthcare Provider Details
I. General information
NPI: 1952483042
Provider Name (Legal Business Name): LESTER E. COX MEDICAL CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2006
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2702 E SUNSHINE ST
SPRINGFIELD MO
65804-2047
US
IV. Provider business mailing address
3800 S NATIONAL AVE #540
SPRINGFIELD MO
65807-5209
US
V. Phone/Fax
- Phone: 417-269-1922
- Fax: 417-269-1930
- Phone: 417-269-6262
- Fax: 417-269-4349
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
P
TAYLOR
Title or Position: VICE PRESIDENT
Credential:
Phone: 417-269-6262