Healthcare Provider Details

I. General information

NPI: 1144734997
Provider Name (Legal Business Name): LESTER E COX MEDICAL CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2017
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 E SUNSHINE ST
SPRINGFIELD MO
65804-1214
US

IV. Provider business mailing address

PO BOX 10939
SPRINGFIELD MO
65808-0939
US

V. Phone/Fax

Practice location:
  • Phone: 417-883-7500
  • Fax:
Mailing address:
  • Phone: 417-883-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAWNA MARIE MORTON
Title or Position: FINANCIAL ANALYST/ASSISTANT TO CFO
Credential:
Phone: 417-269-5951