Individual
MR. FRANK J VILLAMAYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2865 JAMES BLVD, POPLAR BLUFF, MO 63901-2803
(573) 776-1100
(573) 776-1107
Mailing address
622 COLLINS DR STE 200, FESTUS, MO 63028-2077
(636) 638-1506
(636) 638-1507
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2008002901
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144479254
—
MO
Enumeration date
09/12/2008
Last updated
10/12/2017
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