Individual
JACOB P PYEATTE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 S MOUNT AUBURN RD, SUITE 318, CAPE GIRARDEAU, MO 63703-4911
(573) 339-1166
(573) 339-7166
Mailing address
PO BOX 843225, KANSAS CITY, MO 64184-3225
(708) 633-1234
(708) 342-7100
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R5H15
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104268
HEALTHLINK
MO
01
—
1912964289
TRIWEST
MO
05
—
1912964289
—
IL
05
—
202513016
—
MO
01
—
697079
ANTHEM BCBS
MO
Enumeration date
04/28/2006
Last updated
05/20/2011
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