Individual
DR. OSAMEDE EDOKPOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1736 E SUNSHINE ST STE 603, SPRINGFIELD, MO 65804-1333
(844) 476-6600
(417) 356-8078
Mailing address
1736 E SUNSHINE ST STE 603, SPRINGFIELD, MO 65804-1333
(844) 476-6600
(417) 356-8078
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2013002773
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326334459
—
MO
05
—
198983001
—
AR
01
—
431560263
TRICARE
MO
01
—
P01222578
RR MCR
MO
Enumeration date
06/27/2011
Last updated
12/31/2025
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