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General NPI Number Information
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NPI Number | 1376658534
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Entity Type | Organization
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Legal Business Name | ALLERGY AND ASTHMA CONSULTANTS OF THE OZARK,LTD
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 10/03/2007
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Provider Practice Location Address
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Address Line | 1233 JEFFERSON ST
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City | JEFFERSON CITY
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State | MO
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Zip | 65109-2469
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Country | US
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Telephone | 573-634-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1233 JEFFERSON ST
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City | JEFFERSON CITY
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State | MO
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Zip | 65109-2469
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Country | US
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Telephone | 573-634-7000
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN,
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Name | WILLIAM EDWARD STRICKER
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Credential | M.D.
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Telephone | 573-634-7000
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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 | 36045
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License Number State | MO
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