Organization
VAN NESS ORTHOPEDICS & SPORTS MEDICINE INC
Active
Organization
VAN NESS ORTHOPEDICS & SPORTS MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY FORD (OFFICE MANAGER)
(573) 756-7779
Entity
Organization
Contact information
Practice address
606 MAPLE VALLEY DR, FARMINGTON, MO 63640-1976
(573) 756-7779
(573) 756-6914
Mailing address
606 MAPLE VALLEY DR, FARMINGTON, MO 63640-1976
(573) 756-7779
(573) 756-6914
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
DO116378
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200036577
MEDICARE RR
MO
05
—
506060300
—
MO
Enumeration date
07/15/2006
Last updated
05/22/2024
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