Individual
ANGEL JAIME ENCISO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 N KEENE ST, SUITE 400, COLUMBIA, MO 65201-8104
(573) 817-3096
(573) 817-6645
Mailing address
402 N KEENE ST, 3RD FLOOR, COLUMBIA, MO 65201-6986
(573) 499-6084
(573) 499-6088
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2013021638
MO
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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