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General NPI Number Information
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NPI Number | 1699057844
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Entity Type | Organization
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Legal Business Name | DOC IN A BOX URGENT CARE LLC
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 12/14/2015
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Provider Practice Location Address
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Address Line | 1000 WEBSTER STREET SUITE 102
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City | MEXICO
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State | MO
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Zip | 65265
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Country | US
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Telephone | 573-581-2347
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Fax | 573-581-9447
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Provider Business Mailing Address
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Address Line | 1000 WEBSTER STREET SUITE 102
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City | MEXICO
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State | MO
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Zip | 65265
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Country | US
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Telephone | 573-581-2347
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Fax | 573-581-9447
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT P SIMMONS
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Credential | MD
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Telephone | 573-581-2347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2009007879
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License Number State | MO
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