# THEODOSIA MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679571590
- **Authorized official:** DR. MARIAN W STEWART D.O. (PHYSICIAN OWNER)
- **Authorized official phone:** (417) 273-4449

## Contact information

- **Practice address:** US HIGHWAY 160, \#1, THEODOSIA, MO 65761
- **Practice address phone:** (417) 273-4449
- **Practice address fax:** (417) 273-4489
- **Mailing address:** 516 IOWA COLONY RD, HOLLISTER, MO 65672-5270
- **Mailing address phone:** (417) 239-0079
- **Mailing address fax:** (417) 239-1228

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | MO | Yes |

## Other

- **Enumeration date:** 07/13/2005
- **Last updated:** 07/21/2022