Healthcare Provider Details

I. General information

NPI: 1588100390
Provider Name (Legal Business Name): LESTER E COX MEDICAL CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2017
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E PRIMROSE ST SUITE 2 WEST
SPRINGFIELD MO
65807-5155
US

IV. Provider business mailing address

PO BOX 9007
SPRINGFIELD MO
65808-9007
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-7246
  • Fax:
Mailing address:
  • Phone: 417-875-3462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateMO

VIII. Authorized Official

Name: MR. ROBERT FERGUSON
Title or Position: VICE PRESIDENT
Credential:
Phone: 417-875-3462