MEDICARE: LESTER E. COX MEDICAL CENTERS

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	207Q00000X	Family Medicine Physician
2	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558391912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LESTER E. COX MEDICAL CENTERS

Provider Business Mailing Address
First Line	:	PO BOX 7411626
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-5626
Country	:	US
Telephone Number	:	417-730-6430
Fax Number	:	417-269-7567

Provider Business Practice Location Address
First Line	:	202 N. COMMERCIAL
Second Line	:
City	:	SEYMOUR
State	:	MO
Zip	:	65746-8858
Country	:	US
Telephone Number	:	417-269-2100
Fax Number	:	417-269-2103

Authorized Official
Title or Position	:	SR VP & CFO
Name	:	JACOB MCWAY
Credential	:
Telephone Number	:	417-269-8811

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	06/17/2025

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