Individual
DR. PHILIP N. WITTMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
Mailing address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R4F31
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24276
BLUE CROSS OF MO
—
05
—
243426806
—
MO
Enumeration date
09/20/2006
Last updated
12/16/2016
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