MEDICARE: DR. DAVID LEE CATHCART 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	207Q00000X	Family Medicine Physician	109547	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00836332	OTHER		RAILROAD MEDICARE

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
3	431560263	OTHER	MO	TRICARE WEST
4	002013314	OTHER	MO	PTAN

General Provider Information

NPI Number	:	1821093287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID LEE CATHCART M.D.

Provider Business Mailing Address
First Line	:	PO BOX 777
Second Line	:	304 W. WASHINGTON AVENUE
City	:	RICHLAND
State	:	MO
Zip	:	65556-0777
Country	:	US
Telephone Number	:	573-765-5131
Fax Number	:	573-765-3122

Provider Business Practice Location Address
First Line	:	948 E US HIGHWAY 54
Second Line	:
City	:	CAMDENTON
State	:	MO
Zip	:	65020-6834
Country	:	US
Telephone Number	:	573-346-4446
Fax Number	:	573-346-7501

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	07/03/2016

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Directions to “ DR. DAVID LEE CATHCART M.D.” Practice Location

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