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General NPI Number Information
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NPI Number | 1205063500
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Entity Type | Organization
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Legal Business Name | ALLERGY AND ASTHMA CONSULTANTS OF THE OZARKS, LTD
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 601 W NIFONG BLVD STE 2B
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City | COLUMBIA
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State | MO
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Zip | 65203-6804
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Country | US
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Telephone | 573-446-7000
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Fax | 573-445-1000
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Provider Business Mailing Address
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Address Line | 601 W NIFONG BLVD STE 2B
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City | COLUMBIA
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State | MO
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Zip | 65203-6804
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Country | US
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Telephone | 573-446-7000
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Fax | 573-445-1000
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHERYL HINES
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Credential |
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Telephone | 573-446-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State |
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