Individual
DR. JUAN CARLOS SALAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1140 HERSCHEL BESS BLVD, POPLAR BLUFF, MO 63901-3075
(573) 686-1200
(573) 686-1029
Mailing address
5716 LAKE SHORE DR, POPLAR BLUFF, MO 63901-9648
(573) 686-2127
(573) 778-4156
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2000174358
MO
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
2000174358
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205345804
—
MO
01
—
431116734
UNITED BEHAVIORAL HEALTH
—
01
—
461695
HEALTHLINK HMO
—
Enumeration date
06/14/2006
Last updated
04/11/2024
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