Healthcare Provider Details

I. General information

NPI: 1013701275
Provider Name (Legal Business Name): LESTER E. COX MEDICAL CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 S NATIONAL AVE
SPRINGFIELD MO
65807-7310
US

IV. Provider business mailing address

3535 S NATIONAL AVE
SPRINGFIELD MO
65807-7310
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-9892
  • Fax: 417-269-9842
Mailing address:
  • Phone: 417-269-9892
  • Fax: 417-269-9842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MAX DAVIS BUETOW
Title or Position: CEO
Credential:
Phone: 417-209-4981