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Organization

LESTER E. COX MEDICAL CENTERS

Active
Other names
REPUBLIC FAMILY HEALTH CARE
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID P TAYLOR (VICE PRESIDENT)
(417) 269-6262
Entity
Organization

Contact information

Practice address
820 S ILLINOIS AVE, REPUBLIC, MO 65738-1177
(417) 269-1910
(417) 269-1916
Mailing address
3800 S NATIONAL AVE, #540, SPRINGFIELD, MO 65807-5209
(417) 269-6262
(417) 269-4349

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201476
BLUE CROSS OF MO
05
505427609
MO
Enumeration date
10/05/2006
Last updated
06/20/2008
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