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General NPI Number Information
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NPI Number | 1942605175
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Entity Type | Organization
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Legal Business Name | MISSOURI CANCER ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/30/2014
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 105 N KEENE ST SUITE 201
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City | COLUMBIA
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State | MO
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Zip | 65201-8131
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Country | US
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Telephone | 573-499-4990
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Fax | 573-442-2120
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Provider Business Mailing Address
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Address Line | 1705 E BROADWAY SUITE 100
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City | COLUMBIA
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State | MO
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Zip | 65201-7166
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Country | US
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Telephone | 573-874-7800
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Fax | 573-874-8620
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW ILIFF
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Credential | MD
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Telephone | 573-874-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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