MEDICARE: DR. CYNTHIA UPTMOR M.D.

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	207P00000X	Emergency Medicine Physician	109126	MO

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	:	1578589412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA UPTMOR M.D.

Provider Business Mailing Address
First Line	:	195 ARROWHEAD LN
Second Line	:
City	:	JACKSON
State	:	MO
Zip	:	63755-4600
Country	:	US
Telephone Number	:	866-916-5259
Fax Number	:	231-922-4030

Provider Business Practice Location Address
First Line	:	2136 WILLIAM ST STE 150
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-5831
Country	:	US
Telephone Number	:	573-339-4546
Fax Number	:

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	04/14/2026

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