MEDICARE: ALLERGY AND ASTHMA CONSULTANTS OF THE OZARK,LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician	36045	MO

General Provider Information

NPI Number	:	1376658534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY AND ASTHMA CONSULTANTS OF THE OZARK,LTD

Provider Business Mailing Address
First Line	:	1233 JEFFERSON ST
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-2469
Country	:	US
Telephone Number	:	573-634-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1233 JEFFERSON ST
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65109-2469
Country	:	US
Telephone Number	:	573-634-7000
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN,
Name	:	WILLIAM EDWARD STRICKER
Credential	:	M.D.
Telephone Number	:	573-634-7000

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	10/03/2007

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