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Individual

MR. JEFFREY S. DELVECCHIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
3050 E RIVER BLUFF BLVD, OZARK, MO 65721-8807
(417) 820-5610
(417) 820-5588
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
114082
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
431560263
TRICARE
MO
01
970010692
RAILROAD MEDICARE
MO
Enumeration date
06/23/2006
Last updated
11/21/2013
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