Organization
ALLERGY AND ASTHMA CONSULTANTS OF THE OZARK,LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LEWIS VANDEWALKER M.D. (PHYSICIAN)
(573) 634-7000
Entity
Organization
Contact information
Practice address
1233 JEFFERSON ST, JEFFERSON CITY, MO 65109-2469
(573) 634-7000
Mailing address
1233 JEFFERSON ST, JEFFERSON CITY, MO 65109-2469
(573) 634-7000
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
R2F17
MO
Other
Enumeration date
08/30/2006
Last updated
10/03/2007
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