Organization
JUNO GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHERYL ANN FOGARTY M.D. (OWNER)
(417) 624-2621
Entity
Organization
Contact information
Practice address
3103 MCCLELLAND BLVD, JOPLIN, MO 64804-1640
(417) 624-2621
(417) 624-4652
Mailing address
PO BOX 3535, JOPLIN, MO 64803-3535
(417) 624-2621
(417) 624-4652
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2003008358
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255634275
—
MO
05
—
200317670A
—
OK
Enumeration date
12/14/2010
Last updated
05/24/2011
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