Individual
ETHAN REZNICEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MERCY WAY STE 1400, JOPLIN, MO 64804-4524
(417) 556-2300
Mailing address
100 MERCY WAY STE 1400, JOPLIN, MO 64804-4524
(417) 556-2300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2021037224
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2017
Last updated
09/23/2021
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