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Individual

MAMIE R. JAYCOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
1229 E SEMINOLE ST, SPRINGFIELD, MO 65804-2227
(417) 820-5750
(417) 820-5066
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
112381
MO
237700000X
Hearing Instrument Specialist
001233
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
174951720
AR
05
339095119
MO
01
P00653974
RAILROAD MEDICARE
Enumeration date
10/13/2006
Last updated
08/11/2009
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