Individual
TIMOTHY ANTHONY FURSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1423 N. JEFFERSON, #B100, SPRINGFIELD, MO 65802-1917
(417) 269-8825
(417) 269-8744
Mailing address
3800 S. NATIONAL AVE, STE. 540, SPRINGFIELD, MO 65807-5284
(417) 269-8825
(417) 269-8744
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2008014375
MO
207Q00000X
Family Medicine Physician
2008014375
MO
207Q00000X
Family Medicine Physician
33651
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780625749
—
MO
05
—
3214536
—
IA
01
—
35131
MIDLANDS
—
01
—
39007
WELLMARK BCBS
—
01
—
P00232672
RAILROAD MEDICARE
—
Enumeration date
06/09/2006
Last updated
04/15/2015
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