Organization
OZARK GASTROENTEROLOGY, INC
Active
Other names
SUDHAKAR ANCHA, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUDHAKAR ANCHA MD (OWNER)
(417) 623-5250
Entity
Organization
Contact information
Practice address
2216 E 32ND STREET, STE 103, JOPLIN, MO 64804
(417) 623-5250
(417) 623-8302
Mailing address
2216 E 32ND STREET, STE 103, JOPLIN, MO 64804
(417) 623-5250
(417) 623-8302
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2005009627
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000093116
MEDICARE P10
MO
01
—
1346395852
INDIVIDUAL NPI
MO
Enumeration date
09/30/2008
Last updated
04/24/2014
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