Individual
DR. SHERI LYNN BETHMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2212 W KEARNEY ST, SPRINGFIELD, MO 65803-2029
(417) 831-8074
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2009014063
MO
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
2012023206
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841427515
—
MO
01
—
431560263
TRICARE
MO
01
—
P01246694
RR MCR
MO
Enumeration date
06/19/2009
Last updated
10/20/2014
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