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Organization

DRS DECKARD AND NEELY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY ANN BECKERS (RECEPTIONIST)
(417) 882-1822
Entity
Organization

Contact information

Practice address
3230 E RIDGEVIEW ST, SPRINGFIELD, MO 65804-4076
(417) 882-1822
(417) 882-7476
Mailing address
3230 E RIDGEVIEW ST, SPRINGFIELD, MO 65804-4076
(417) 882-1822
(417) 882-7476

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2003014006
MO
174400000X
Specialist
33472
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000654
MEDICARE PTAN NUMBER
MO
Enumeration date
08/06/2009
Last updated
08/06/2009
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