Organization
LESTER E. COX MEDICAL CENTERS
Active
Other names
Pediatric Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID TAYLOR (VICE PRESIDENT)
(417) 269-4381
Entity
Organization
Contact information
Practice address
1000 E PRIMROSE ST, STE 170, SPRINGFIELD, MO 65807-5154
(417) 269-0930
Mailing address
1000 E PRIMROSE ST, STE 170, SPRINGFIELD, MO 65807-5154
(417) 269-0930
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212833
BCBS MO
MO
01
—
217514
BCBS MO
MO
Enumeration date
08/07/2007
Last updated
08/07/2007
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