Organization
PEDIATRIC ASSOCIATES OF SOUTHWEST MISSOURI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE A YARNALL (MANAGING MEMBER)
(417) 782-5522
Entity
Organization
Contact information
Practice address
2719 E 32ND ST, JOPLIN, MO 64804-3131
(417) 782-5522
(417) 622-5498
Mailing address
2719 E 32ND ST, JOPLIN, MO 64804-3131
(417) 782-5522
(417) 622-5498
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500214705
—
MO
Enumeration date
03/22/2007
Last updated
08/29/2023
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