Healthcare Provider Details
I. General information
NPI: 1619023330
Provider Name (Legal Business Name): ALLERGY & ASTHMA CONSULTANTS OF THE OZARKS LTD.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
407 A. EAST RUSSELL AVE. SUITE 3
WARRENSBURG MO
64093
US
IV. Provider business mailing address
407 A. EAST RUSSELL AVENUE SUITE 3
WARRENSBURG MO
64093
US
V. Phone/Fax
- Phone: 660-422-7000
- Fax: 660-747-0409
- Phone: 660-422-7000
- Fax: 660-747-0409
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WILLIAM
E
STRICKER
Title or Position: PRESIDENT
Credential:
Phone: 660-422-7000