Individual
DR. ALAN S JO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 269-7728
(417) 269-7729
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2002009961
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
155699
BLUE CROSS MO
—
05
—
205820707
—
MO
Enumeration date
08/14/2006
Last updated
03/07/2019
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