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NPI Code Detail

MEDICARE: MS. SANDRA KAY DEMPSEY P.A. - C.

MEDICARE: MS. SANDRA KAY DEMPSEY P.A. - C.
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
1363AM0700XMedical Physician Assistant2002018245MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00635678OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2431560263OTHERTRICARE WEST

General Provider Information

NPI Number : 1861490773
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SANDRA KAY DEMPSEY P.A. - C.
Provider Business Mailing Address
First Line : 107 W ELDON ST
Second Line :
City : SAINT JAMES
State : MO
Zip : 65559-1903
Country : US
Telephone Number : 573-265-1818
Fax Number : 573-265-1810
Provider Business Practice Location Address
First Line : 107 W ELDON ST
Second Line :
City : SAINT JAMES
State : MO
Zip : 65559-1903
Country : US
Telephone Number : 573-265-1818
Fax Number : 573-265-1810
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 01/08/2009

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