Individual
JOHN D UPDEGROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2457 NE COUNTY ROAD 0080, CORSICANA, TX 75109-8414
(903) 654-0457
Mailing address
2457 NE COUNTY ROAD 0080, CORSICANA, TX 75109-8414
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
H0897
TX
207RP1001X
Pulmonary Disease Physician
Primary
H0897
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136617111
—
TX
Enumeration date
02/23/2006
Last updated
05/06/2020
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