Individual
DR. REBECCA J WOTHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
222 E PRIMROSE ST, SUITE E, SPRINGFIELD, MO 65807-5206
(417) 553-1080
(888) 712-7702
Mailing address
101 S PARK LN, ALTUS, OK 73521-5731
(580) 379-6100
(580) 379-6109
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
102581
MO
208000000X
Pediatrics Physician
Primary
29631
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200014010B
—
OK
05
—
202710364
—
MO
Enumeration date
10/10/2006
Last updated
08/17/2015
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