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General NPI Number Information
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NPI Number | 1376515080
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Entity Type | Individual
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Provider Name | DEBRA A ATKINSON MD
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Gender | Female
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 1870 BAGNELL DAM BLVD
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City | LAKE OZARK
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State | MO
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Zip | 65049-8658
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Country | US
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Telephone | 573-365-2318
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Fax | 573-365-3009
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Provider Business Mailing Address
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Address Line | 67 SILVER CREEK LN
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City | ELDON
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State | MO
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Zip | 65026-5430
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Country | US
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Telephone | 573-280-0672
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2000162958
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License Number State | MO
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