Individual
DR. JOHN M MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
805 KENTUCKY AVE., WEST PLAINS, MO 65775
(417) 256-2111
(417) 256-4858
Mailing address
805 KENTUCKY AVE., WEST PLAINS, MO 65775
(417) 256-2111
(417) 256-4858
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
R3B70
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201249521
—
MO
05
—
599022307
—
MO
05
—
599022308
—
MO
01
—
P00207389
MEDICARE RR
—
Enumeration date
06/20/2005
Last updated
01/23/2008
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