Individual
MR. MARK J SCHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3805 S KANSAS EXPY STE B, SPRINGFIELD, MO 65807-6989
(417) 269-0269
(417) 269-0279
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 739-4510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
105617
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1010052219
RAILROAD MEDICARE
—
01
—
1673
COX HEALTH SYSTEMS
—
05
—
206034001
—
MO
01
—
257824
HEALTHLINK
—
01
—
3422
BCBS
—
01
—
P00242261
RAILROAD MEDICARE
—
Enumeration date
06/19/2006
Last updated
03/22/2018
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