Individual
PAUL WILLIAM HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3220 BLUFF CREEK DR, STE 100, COLUMBIA, MO 65201-3525
(573) 443-8773
(573) 443-6843
Mailing address
3220 BLUFF CREEK DR, SUITE 100, COLUMBIA, MO 65201-3525
(573) 443-8773
(573) 443-6843
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
R8N86
MO
2086S0129X
Vascular Surgery Physician
Primary
R8N86
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1284581
UNITED HEALTHCARE
MO
01
—
18421
ANTHEM BLUECROSS BLUESHIE
MO
05
—
203559109
—
MO
01
—
223429
HEALTHLINK, INC
MO
01
—
28058
GHP
MO
01
—
342470
PHCS
MO
01
—
3476
HEALTHCARE USA
MO
01
—
431428562
GREAT WEST
MO
01
—
4343322
AETNA
MO
01
—
F37040
MERCY
MO
Enumeration date
06/09/2005
Last updated
11/22/2021
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