Individual
DR. JO ELLEN FEUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3231 S NATIONAL AVE, STE 400, SPRINGFIELD, MO 65807-7304
(417) 888-5664
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
2011013357
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346420593
—
MO
05
—
188911001
—
AR
01
—
431560263
TRICARE
MO
01
—
P00990412
MCR RR
MO
Enumeration date
11/05/2007
Last updated
03/28/2014
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