Individual
DR. DIANA LYNN ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 E PRIMROSE ST, SPRINGFIELD, MO 65807-5154
(417) 269-9812
(417) 269-9853
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2006022625
MO
208000000X
Pediatrics Physician
E3244
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146263001
—
AR
05
—
206273500
—
MO
Enumeration date
04/26/2006
Last updated
12/18/2019
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