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Individual

WAYNE E PUTNAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 875-3000
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 875-3000

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
R8688
MO
2085N0700X
Neuroradiology Physician
R8688
MO
2085N0904X
Nuclear Radiology Physician
R8688
MO
2085P0229X
Pediatric Radiology Physician
R8688
MO
2085R0202X
Diagnostic Radiology Physician
Primary
R8688
MO
2085R0203X
Therapeutic Radiology Physician
R8688
MO
2085R0204X
Vascular & Interventional Radiology Physician
R8688
MO
2085U0001X
Diagnostic Ultrasound Physician
R8688
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
240698217
MO
Enumeration date
11/09/2006
Last updated
09/22/2021
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