Individual
MICHAEL J PACE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 W HICKORY ST, NEOSHO, MO 64850-1705
(417) 451-1234
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2016017569
MO
207P00000X
Emergency Medicine Physician
4490
OK
207Q00000X
Family Medicine Physician
4490
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200059690A
—
OK
05
—
200115370A
—
OK
05
—
206321200
—
MO
05
—
500359203
—
MO
Enumeration date
04/23/2007
Last updated
09/07/2023
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