Individual
DR. THERESE MCBRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(501) 960-2005
Mailing address
316 N WALL AVE, JOPLIN, MO 64801-2438
(501) 960-2005
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2010016632
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06080015400
QUALCHOICE
—
05
—
155327003
—
AR
01
—
5N047
BCBS
—
01
—
71604624206
QUALCHOICE
—
01
—
E4188
TRICARE
—
01
—
P00355181
RAILROAD MEDICARE 1
—
Enumeration date
08/13/2006
Last updated
03/29/2012
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