Individual
JAY L PEARCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3000
(417) 875-3696
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 875-3000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
115678
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
189109
BLUE CROSS/BLUE SHIELD
—
05
—
205867302
—
MO
05
—
205867310
—
MO
Enumeration date
06/14/2006
Last updated
10/10/2023
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