Individual
DR. JAMES D DEXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 348-8000
(573) 348-8069
Mailing address
PO BOX 1500, OSAGE BEACH, MO 65065-1500
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
29097
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200467835
—
MO
01
—
964233557
MEDICARE PTAN
MO
01
—
P00432174
RAILROAD MEDICARE
MO
Enumeration date
01/26/2007
Last updated
03/07/2012
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