Individual
MAGNUS O. MEYER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-6569
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
R4G32
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538258702
—
MO
05
—
186003003
—
AR
01
—
431560263
TRICARE
MO
01
—
P00912918
RR MCR
MO
Enumeration date
10/12/2006
Last updated
05/01/2013
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