MEDICARE: DR. DONALD J METRY JR. MD

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	207R00000X	Internal Medicine Physician	R8N57	MO

General Provider Information

NPI Number	:	1447296470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD J METRY JR. MD

Provider Business Mailing Address
First Line	:	103 ELEVENTH ST
Second Line	:	SUITE 11
City	:	CHILLICOTHEE
State	:	MO
Zip	:	64601
Country	:	US
Telephone Number	:	660-646-6411
Fax Number	:	660-646-5881

Provider Business Practice Location Address
First Line	:	103 11TH ST
Second Line	:	SUITE 11
City	:	CHILLICOTHEE
State	:	MO
Zip	:	64601-1676
Country	:	US
Telephone Number	:	660-646-6411
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	03/09/2010

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