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Individual

JUAN GUSTAVO NIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3011
(417) 326-6000
Mailing address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3011
(417) 326-6000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MOR1G61
MO

Other

Enumeration date
11/16/2006
Last updated
12/02/2009
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