Individual
DR. JOHN THOMAS PESSONEY
Active
Individual
DR. JOHN THOMAS PESSONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
2003000629
MO
2083X0100X
Occupational Medicine Physician
Primary
20863
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204642102
MEDICAID
MO
05
—
243419306
—
MO
Enumeration date
09/11/2006
Last updated
04/29/2010
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