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Individual

JEREMY D MABE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1150 STATE HIGHWAY 248, STE. 202, BRANSON, MO 65616-3758
(417) 348-8964
(417) 336-0275
Mailing address
1150 STATE HIGHWAY 248, STE. 202, BRANSON, MO 65616-3758
(417) 348-8964
(417) 336-0275

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2000154576
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080174333
RAILROAD MEDICARE
01
14189
COX HEALTH SYSTEMS
01
144172
BCBS
05
205804610
MO
05
208887414
MO
01
462206
HEALTHLINK
Enumeration date
06/16/2006
Last updated
03/24/2014
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