Organization
REGIONAL SERVICES
Active
Other names
CoxHealth Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MAX BUETOW (VICE PRESIDENT)
(417) 631-0381
Entity
Organization
Contact information
Practice address
3850 S NATIONAL AVE, STE 700, SPRINGFIELD, MO 65807-5287
(417) 269-0700
(417) 269-0709
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206392
BLUE CROSS
—
05
—
500856307
—
MO
Enumeration date
11/29/2006
Last updated
03/14/2017
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