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General NPI Number Information
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NPI Number | 1922035070
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Entity Type | Individual
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Provider Name | JOHN T SYMONDS DO
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Gender | Male
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 2016 S MAIN ST
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City | MARYVILLE
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State | MO
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Zip | 64468-2655
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Country | US
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Telephone | 660-562-7099
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Fax | 660-562-7999
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Provider Business Mailing Address
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Address Line | 2016 S MAIN ST
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City | MARYVILLE
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State | MO
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Zip | 64468-2655
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Country | US
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Telephone | 660-562-2600
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Fax | 660-562-7911
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 77
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2007010486
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License Number State | MO
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