Individual
DR. ERICH MERTENSMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1229 E SEMINOLE ST, STE 520, SPRINGFIELD, MO 65804-2227
(417) 820-5750
(417) 820-5066
Mailing address
1229 E SEMINOLE ST, SPRINGFIELD, MO 65804-2227
(417) 829-5750
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
2003013945
MO
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
2003013945
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396861498
—
MO
05
—
191683003
—
AR
01
—
431560263
TRICARE
MO
01
—
P01036353
RR MCR
MO
Enumeration date
03/21/2007
Last updated
09/25/2019
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