Individual
DR. MARK DARL BRECHEISEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 269-6583
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2011026828
MO
208M00000X
Hospitalist Physician
2011026828
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740503416
—
MO
05
—
209646009
—
MO
Enumeration date
03/09/2010
Last updated
08/30/2022
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