Healthcare Provider Details

I. General information

NPI: 1629088570
Provider Name (Legal Business Name): ONCOLOGY-HEMATOLOGY ASSOCIATES OF SPRINGFIELD, MD,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 S NATIONAL AVE SUITE 600
SPRINGFIELD MO
65807-5287
US

IV. Provider business mailing address

3850 S NATIONAL AVE SUITE 600
SPRINGFIELD MO
65807-5287
US

V. Phone/Fax

Practice location:
  • Phone: 417-882-4880
  • Fax: 417-882-7213
Mailing address:
  • Phone: 417-882-4880
  • Fax: 417-882-7213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID E HART
Title or Position: ADMINISTRATOR
Credential:
Phone: 417-882-4880