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Organization

ANTHONY ZOFFUTO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JULIE WHITESIDES (ACCOUNT MANAGER)
(800) 540-6575
Entity
Organization

Contact information

Practice address
211 SAINT FRANCIS DR, CAPE GIRARDEAU, MO 63703-5049
(573) 331-5330
Mailing address
PO BOX 1286, COLUMBIA, MO 65205-1286
(800) 540-6575
(573) 499-9418

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R4523
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CK6400
RAILROAD MEDICARE
Enumeration date
10/18/2006
Last updated
12/12/2007
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