Individual
DR. JESSICA ANNE BIRCHEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2115 S FREMONT AVE, SUITE 4300, SPRINGFIELD, MO 65804-2239
(417) 820-3911
(417) 820-3924
Mailing address
2115 S FREMONT AVE, SUITE 4300, SPRINGFIELD, MO 65804
(417) 829-3911
(417) 829-3924
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
2004022163
MO
207RI0011X
Interventional Cardiology Physician
Primary
2004022163
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285803353
—
MO
05
—
182624003
—
AR
01
—
431560263
TRICARE WEST
MO
01
—
P00836336
RAILROAD MEDICARE
—
Enumeration date
02/22/2008
Last updated
07/05/2017
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