Individual
JANET E THEBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2707 W EDGEWOOD DR, JEFFERSON CITY, MO 65109-5888
(573) 635-0233
(573) 635-7436
Mailing address
2707 W EDGEWOOD DR, JEFFERSON CITY, MO 65109-5888
(573) 635-0233
(573) 635-7436
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
105073
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080187712
RR MEDICARE
—
01
—
080193832
RR MEDICARE
—
01
—
1196653
FIRST HEALTH
—
05
—
206878233
—
MO
05
—
206878241
—
MO
05
—
206878258
—
MO
01
—
241056
HEALTHLINK
—
01
—
25147
BLUE CROSS BLUE SHIELD
—
01
—
44 0546366
UNITED HEALTHCARE
—
01
—
4640661
CIGNA
—
05
—
500383609
—
MO
05
—
501607808
—
MO
05
—
508069101
—
MO
01
—
B08074
MERCY
—
01
—
CD6730
RR MEDICARE
—
01
—
CH5818
RR MEDICARE
—
01
—
CK7821
RR MEDICARE
—
01
—
P00099221
RR MEDICARE
—
Enumeration date
01/05/2006
Last updated
09/24/2013
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