Healthcare Provider Details

I. General information

NPI: 1801118385
Provider Name (Legal Business Name): SPRINGFIELD GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 02/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E SUNSHINE ST STE 1
SPRINGFIELD MO
65807-2652
US

IV. Provider business mailing address

2025 ZUMBEHL RD STE 83
SAINT CHARLES MO
63303
US

V. Phone/Fax

Practice location:
  • Phone: 314-560-3119
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number StateMO

VIII. Authorized Official

Name: A W SCHOTT
Title or Position: PRESIDENT
Credential:
Phone: 314-560-3119