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NPI Code Detail

MEDICARE: MR. JOSEPH BRENT GILSTRAP L.P.C.

MEDICARE:  MR. JOSEPH BRENT GILSTRAP  L.P.C.
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
1101YP2500XProfessional CounselorCS002654MO

General Provider Information

NPI Number : 1427118710
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH BRENT GILSTRAP L.P.C.
Provider Business Mailing Address
First Line : 5835 N FARM ROAD 171
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65803-8641
Country : US
Telephone Number : 417-833-2597
Fax Number :
Provider Business Practice Location Address
First Line : 415 E WALNUT ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65806-2303
Country : US
Telephone Number : 417-693-3313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2006
Last Update Date : 07/08/2007

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Directions to “ MR. JOSEPH BRENT GILSTRAP L.P.C.” Practice Location

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