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Individual

GARY L MEHLHORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1229 E SEMINOLE ST, SPRINGFIELD, MO 65804-2227
(417) 820-9393
(417) 820-9725
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R5C89
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201657616
MO
Enumeration date
07/22/2005
Last updated
10/20/2014
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