Individual
DR. LUKE PHILIP REINE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2711 S MEADOWBROOK AVE, SPRINGFIELD, MO 65807-5924
(417) 887-0081
(417) 227-1412
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2008015988
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780848341
—
MO
Enumeration date
07/14/2008
Last updated
10/03/2014
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