Organization
CENTRAL MO EAR, NOSE, THROAT, & SINUS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J MCDONALD MD (OWNER)
(573) 659-5570
Entity
Organization
Contact information
Practice address
3527 W TRUMAN BLVD STE 200, JEFFERSON CITY, MO 65109-5902
(573) 659-5570
(573) 659-5577
Mailing address
3527 W TRUMAN BLVD STE 200, JEFFERSON CITY, MO 65109-5902
(573) 659-5570
(573) 659-5577
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MDR1K87
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24321
BLUE CROSS BLUE SHIELD
MO
05
—
504611609
—
MO
01
—
DG6216
RAILROAD MEDICARE
MO
Enumeration date
02/14/2007
Last updated
08/17/2022
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