Individual
DR. BOBBY W PITTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
703 US HIGHWAY 90 E, SUITE 108, CASTROVILLE, TX 78009-5246
(417) 773-1703
Mailing address
703 US HIGHWAY 90 E, SUITE 108, CASTROVILLE, TX 78009-5246
(417) 773-1703
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD115594
MO
207Q00000X
Family Medicine Physician
Primary
N5339
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129203
BLUE CROSS OF MO
—
05
—
205252901
—
MO
05
—
214999901
—
TX
Enumeration date
09/24/2006
Last updated
02/26/2012
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