Healthcare Provider Details

I. General information

NPI: 1942638176
Provider Name (Legal Business Name): LESTER E COX MEDICAL CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2013
Last Update Date: 11/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2224 W SUNSET ST
SPRINGFIELD MO
65807-5980
US

IV. Provider business mailing address

1423 N JEFFERSON AVE
SPRINGFIELD MO
65802-1917
US

V. Phone/Fax

Practice location:
  • Phone: 417-730-2000
  • Fax: 417-730-2019
Mailing address:
  • Phone: 417-269-3000
  • Fax: 417-269-3104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. JACOB M MCWAY
Title or Position: SR VICE-PRESIDENT & CFO
Credential:
Phone: 417-269-8811