Organization
ORAL ANESTHESIA GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE ANN GIPSON MBA,CASC (ADMINISTRATOR)
(417) 447-2482
Entity
Organization
Contact information
Practice address
1103 E MONTCLAIR ST, SUITE 110, SPRINGFIELD, MO 65807-5076
(417) 447-2482
Mailing address
1103 E MONTCLAIR ST, SUITE 110, SPRINGFIELD, MO 65807-5076
(417) 447-2482
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507601508
—
MO
Enumeration date
02/27/2007
Last updated
04/15/2013
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