Organization
SOUTHWEST GASTROENTEROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. XUJUN WU M.D. (PRESIDENT)
(330) 409-3337
Entity
Organization
Contact information
Practice address
2817 MC CLELLAND BLVD, SUITE 153, JOPLIN, MO 64804-1629
(417) 206-4928
(417) 206-4734
Mailing address
2817 MC CLELLAND BLVD, SUITE 153, JOPLIN, MO 64804-1629
(417) 206-4928
(417) 206-4734
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2006024391
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006024391
STATE OF MO LICENSE
MO
05
—
2514363
—
OH
Enumeration date
08/17/2006
Last updated
08/22/2020
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