Individual
JOHN T SYMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2016 S MAIN ST, MARYVILLE, MO 64468-2655
(660) 562-7099
(660) 562-7999
Mailing address
2016 S MAIN ST, MARYVILLE, MO 64468-2655
(660) 562-2600
(660) 562-7911
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2007010486
MO
208D00000X
General Practice Physician
77
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07049
BLUE CROSS BLUE SHIELD NE
NE
01
—
080017219
PALMETTO GBA RR MEDICARE
—
Enumeration date
06/26/2006
Last updated
10/10/2019
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