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Individual

BALKOZAR S ADAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R5G05
MO
2084P0804X
Child & Adolescent Psychiatry Physician
R5G05
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
203506407
MO
Enumeration date
12/06/2006
Last updated
02/14/2025
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