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General NPI Number Information
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NPI Number | 1134343098
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Entity Type | Organization
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Legal Business Name | JOPLIN UROLOGY ASSOCIATES INC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 04/20/2009
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Provider Practice Location Address
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Address Line | 3302 MCINTOSH CIR SUITE 2
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City | JOPLIN
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State | MO
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Zip | 64804-3648
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Country | US
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Telephone | 417-623-3703
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Fax | 417-782-7726
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Provider Business Mailing Address
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Address Line | 3302 MCINTOSH CIR SUITE 2
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City | JOPLIN
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State | MO
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Zip | 64804-3648
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Country | US
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Telephone | 417-623-3703
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Fax | 417-782-7726
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES M FROGGE
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Credential | M.D.
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Telephone | 417-623-3703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 117878
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License Number State | MO
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