Individual
DR. CHRISTOPHER RYAN LONGNECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1102 W 32ND ST, SUITE 300, JOPLIN, MO 64804-3503
(417) 347-5000
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-5000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2004027787
MO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2004027787
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209328509
—
MO
Enumeration date
05/30/2005
Last updated
04/20/2011
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