Healthcare Provider Details

I. General information

NPI: 1033346267
Provider Name (Legal Business Name): ALLERGY AND ASTHMA CONSULTANTS OF THE OZARKS, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 06/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407A E RUSSELL AVE STE 3
WARRENSBURG MO
64093-1266
US

IV. Provider business mailing address

407A E RUSSELL AVE STE 3
WARRENSBURG MO
64093-1266
US

V. Phone/Fax

Practice location:
  • Phone: 660-422-7000
  • Fax: 660-747-0409
Mailing address:
  • Phone: 660-422-7000
  • Fax: 660-747-0409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: LINDA MILLER
Title or Position: BILLING SPECIALIST
Credential:
Phone: 660-422-7000