Organization
REGIONAL SERVICES
Active
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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