Organization
REGIONAL SERVICES
Active
Other names
Robert D. Bazley, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID P. TAYLOR (VICE PRESIDENT)
(417) 269-6262
Entity
Organization
Contact information
Practice address
815 N LINCOLN AVE, #D, MONETT, MO 65708-1641
(417) 236-2475
(417) 354-1458
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-7834
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201481
BLUE CROSS
—
05
—
506300706
—
MO
Enumeration date
11/17/2006
Last updated
05/21/2008
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