Organization
CAPE GIRARDEAU UROLOGY ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA NUSSBAUM (OFFICE MANAGER)
(573) 334-7748
Entity
Organization
Contact information
Practice address
3 DOCTORS PARK, CAPE GIRARDEAU, MO 63703-4927
(573) 334-7748
(573) 334-5724
Mailing address
3 DOCTORS PARK, CAPE GIRARDEAU, MO 63703-4927
(573) 334-7748
(573) 334-5724
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107662
HEALTHLINK
—
05
—
500616602
—
MO
01
—
628
BLUE CROSS BLUE SHIELD
—
01
—
CP7010
RAILROAD MEDICARE
—
Enumeration date
08/05/2006
Last updated
02/08/2016
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