Individual
DR. SIMON JOHN MCKEOWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3626 S CLARK ST, MEXICO, MO 65265-4104
(573) 581-1812
(573) 581-1471
Mailing address
P.O. BOX 478, MEXICO, MO 65265
(573) 581-8127
(573) 582-7053
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2004021597
MO
207Q00000X
Family Medicine Physician
Primary
2004021597
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205459308
—
MO
Enumeration date
07/12/2006
Last updated
11/21/2022
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