Individual
DR. TIMOTHY R. SONCASIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 W NIFONG BLVD STE 101, COLUMBIA, MO 65203
(573) 499-9009
(573) 499-4400
Mailing address
900 W NIFONG BLVD STE 101, COLUMBIA, MO 65203-4469
(573) 499-9009
(573) 499-4400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
111504
MO
208000000X
Pediatrics Physician
111504
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208504514
—
MO
01
—
P00349316
RR MEDICARE
MO
Enumeration date
07/20/2006
Last updated
08/06/2019
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