Individual
JOHN R. CARLILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E. PRIMROSE, #200, SPRINGFIELD, MO 65807-5388
(417) 269-1010
(417) 269-6755
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-1010
(417) 269-6755
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
R8242
MO
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
14730
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100199150 A
—
OK
01
—
196616
BLUE SHIELD
MO
05
—
202969408
—
MO
01
—
701434
HEALTHLINK
MO
Enumeration date
06/02/2006
Last updated
07/01/2013
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