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Individual

DR. ROBERT L. ELWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1423 N JEFFERSON AVE, SPRINGFIELD, MO 65802-1917
(417) 269-2273
(417) 269-8851
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
R4D87
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100276
BLUE
05
202079133
MO
Enumeration date
08/30/2006
Last updated
02/07/2019
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