Individual
DR. CALEB PACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
800 S ASH ST, NEVADA, MO 64772-3224
(417) 667-2121
Mailing address
208 N BONDA WAY, NIXA, MO 65714-7940
(816) 898-9908
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
12-00465
KS
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2020011189
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000014962
MEDICARE
MO
01
—
785000141
MEDICARE
MO
05
—
830087368
—
MO
Enumeration date
06/22/2017
Last updated
07/20/2023
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