Individual
LEONARD WAYNE BRIDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
256 STATE HIGHWAY Y, FORSYTH, MO 65653-5618
(417) 546-4200
(417) 546-4505
Mailing address
PO BOX 1240, FORSYTH, MO 65653-1240
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
114104
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184796
WA STATE LABOR UNION
WA
01
—
121791
BLUE CROSS BLUE SHIELD
MO
Enumeration date
03/15/2007
Last updated
12/31/2007
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