Organization
MEDSTOP ONE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J. CANTRELL (BUSINESS MANAGER)
(573) 335-4100
Entity
Organization
Contact information
Practice address
3065 WILLIAM ST, SUITE 209, CAPE GIRARDEAU, MO 63703-6393
(573) 335-4100
(573) 339-7887
Mailing address
3065 WILLIAM ST, STE 209, CAPE GIRARDEAU, MO 63703-6393
(573) 335-4100
(573) 339-7887
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175986
HEALTHLINK
MO
01
—
218453
BLUE CROSS
MO
05
—
593915200
—
MO
Enumeration date
08/12/2005
Last updated
07/21/2022
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