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General NPI Number Information
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NPI Number | 1568642452
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Entity Type | Organization
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Legal Business Name | OTOLARYNGOLOGY OF JOPLIN
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 1920 E. 32ND ST.
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City | JOPLIN
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State | MO
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Zip | 64804
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Country | US
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Telephone | 417-781-4613
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Fax | 417-781-0805
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Provider Business Mailing Address
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Address Line | 1920 E. 32ND ST.
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City | JOPLIN
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State | MO
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Zip | 64804
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Country | US
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Telephone | 417-781-4613
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Fax | 417-781-0805
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Authorized Official
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Title or Position | OTOLARYNGOLOGIST
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Name | DR. RENEE A WALKER
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Credential | D.O.
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Telephone | 417-781-4613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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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 | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 104366
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License Number State | MO
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