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Individual

DR. ROBERT M CAVAGNOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1965 S FREMONT AVE, SUITE 100, SPRINGFIELD, MO 65804-2201
(417) 820-3800
(417) 820-3810
Mailing address
1965 S FREMONT AVE, SUITE 100, SPRINGFIELD, MO 65804-2201
(417) 820-3800
(417) 820-3810

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2007026645
MO
208600000X
Surgery Physician
35086247
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1043273188
MO
05
168867001
AR
01
431560263
TRICARE WEST
MO
01
P00709670
RAILROAD MEDICARE
Enumeration date
04/10/2006
Last updated
07/13/2009
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