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General NPI Number Information
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NPI Number | 1922471200
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Entity Type | Organization
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Legal Business Name | DHP OF MISSOURI PC
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 100 MERCY WAY STE 430
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City | JOPLIN
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State | MO
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Zip | 64804-4524
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Country | US
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Telephone | 417-556-2278
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Fax |
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Provider Business Mailing Address
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Address Line | 5870 HIATUS RD STE 200
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City | TAMARAC
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State | FL
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Zip | 33321-6424
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANDAL DABBS
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Credential | MD
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Telephone | 865-293-5210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist 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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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