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General NPI Number Information
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NPI Number | 1174821714
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Entity Type | Organization
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Legal Business Name | CYNERGY HEALTH, LLC
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 1100 CLUB VILLAGE DR STE 102
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City | COLUMBIA
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State | MO
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Zip | 65203-4411
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Country | US
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Telephone | 573-447-4400
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Fax | 573-303-0140
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Provider Business Mailing Address
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Address Line | 1100 CLUB VILLAGE DR STE 102
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City | COLUMBIA
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State | MO
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Zip | 65203-4411
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Country | US
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Telephone | 573-447-4400
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Fax | 573-303-0140
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA S HAYES
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Credential | M.D.
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Telephone | 573-447-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20000160625
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License Number State | MO
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