Organization
BROADWAY INTERNAL MEDICINE ASSOCIATES L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS EUGENE VOGT M.D. (OWNER/PHYSICIAN)
(573) 442-0320
Entity
Organization
Contact information
Practice address
204 N KEENE ST, SUITE 100, COLUMBIA, MO 65201-8102
(573) 442-0320
(573) 442-0421
Mailing address
204 N KEENE ST, SUITE 100, COLUMBIA, MO 65201-8102
(573) 442-0320
(573) 442-0421
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
503817504
—
MO
Enumeration date
05/01/2006
Last updated
06/25/2014
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