Individual
MICHAEL D DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1130 E 32ND ST, JOPLIN, MO 64804-4034
(417) 347-2273
(417) 347-2277
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-2273
(417) 347-2277
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2021010406
MO
207Q00000X
Family Medicine Physician
3714
OK
207Q00000X
Family Medicine Physician
DO05122
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100197510C
OSU-INDIVIDUAL
OK
05
—
100197510E
—
OK
01
—
200470610D
OSU-GROUP
OK
05
—
200505990B
—
OK
Enumeration date
07/12/2005
Last updated
05/05/2021
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