Organization
ALLERGY & ASTHMA CONSULTANTS OF THE OZARKS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FERN CONAWAY (OFFICE MANAGER)
(573) 368-7000
Entity
Organization
Contact information
Practice address
509 E 10TH ST, ROLLA, MO 65401-3302
(573) 368-7000
(573) 364-6570
Mailing address
1233 JEFFERSON ST, JEFFERSON CITY, MO 65109-2409
(573) 634-7000
(573) 634-3120
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000003203
MEDICARE PTAN
MO
01
—
000004653
MEDICARE PTAN
MO
01
—
000004944
MEDICARE PTAN
MO
05
—
500076609
—
MO
Enumeration date
05/04/2006
Last updated
05/03/2016
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