Organization
REGIONAL SERVICES
Active
Other names
COXHEALTH PEDIATRIC SPECIALTIES, COXHEALTH PEDIATRIC SPECIALTIES MEDICAL SOUTH
Organization subpart
No
Provider details
NPI number
Authorized official
MAX BUETOW (VICE PRESIDENT)
(417) 631-0381
Entity
Organization
Contact information
Practice address
1000 E PRIMROSE ST, SUITE 200, SPRINGFIELD, MO 65807
(417) 269-1010
(417) 269-6755
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500034004
—
MO
Enumeration date
11/24/2006
Last updated
06/22/2018
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