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Individual

JOHN VAN EARNHART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1111 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-3437
(573) 332-6000
Mailing address
1111 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-3437
(573) 332-6000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-106126
IL
207Q00000X
Family Medicine Physician
Primary
2013002771
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036-106126
IL
01
036106126
IDPA FEE FOR SERVICE
IL
01
076839
HEALTH ALLIANCE
IL
05
1043218084
MO
01
473444
HEALTHLINK
IL
01
H67921
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/13/2005
Last updated
05/12/2026
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