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General NPI Number Information
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NPI Number | 1255820510
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Entity Type | Organization
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Legal Business Name | URGENT SPECIALISTS LLC
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Dates
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Enumeration Date | 05/02/2018
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 14169 MANCHESTER RD STE C
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City | MANCHESTER
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State | MO
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Zip | 63011-4525
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Country | US
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Telephone | 636-220-1470
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Fax |
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Provider Business Mailing Address
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Address Line | 2120 W INA RD STE 100
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City | TUCSON
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State | AZ
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Zip | 85741-5501
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Country | US
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Telephone | 520-395-0471
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MS. REGINA SIMO
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Credential |
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Telephone | 314-308-7681
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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