MEDICARE: ROBERT H BLACKSHEAR 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	207L00000X	Anesthesiology Physician	1999141055	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	194111	OTHER	MO	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	20174319965616C002	OTHER	MO	TRICARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	421313	OTHER	MO	HEALTHLINK
7	P00194816	OTHER	MO	RAILROAD
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	9917	OTHER	MO	COX HEALTH

General Provider Information

NPI Number	:	1760477954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT H BLACKSHEAR MD

Provider Business Mailing Address
First Line	:	449 S OAKS DR
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65809-1101
Country	:	US
Telephone Number	:	417-496-6654
Fax Number	:

Provider Business Practice Location Address
First Line	:	449 S OAKS DR
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65809-1101
Country	:	US
Telephone Number	:	417-496-6654
Fax Number	:

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	08/16/2021

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Directions to “ ROBERT H BLACKSHEAR MD” Practice Location

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