Individual
DR. ERIC D BETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2003 W BROADWAY, SUITE 100, COLUMBIA, MO 65203-1111
(573) 777-5880
(573) 777-5875
Mailing address
2003 W BROADWAY, SUITE 100, COLUMBIA, MO 65203-1111
(573) 777-5880
(573) 777-5875
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
112989
MO
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
112989
MO
207Q00000X
Family Medicine Physician
112989
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116134
BLUE CROSS/BLUE SHIELD
—
Enumeration date
08/30/2006
Last updated
06/25/2020
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