Organization
LESTER E. COX MEDICAL CENTERS
Active
Other names
AVA FAMILY HEALTH CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID P. TAYLOR (VICE PRESIDENT)
(417) 269-6262
Entity
Organization
Contact information
Practice address
806 SW 13TH AVE, AVA, MO 65608
(417) 683-7200
(417) 683-0165
Mailing address
3800 S NATIONAL AVE, #540, SPRINGFIELD, MO 65807-5209
(417) 269-6262
(417) 269-4349
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116756
BLUE CROSS OF MO
—
05
—
505978502
—
MO
Enumeration date
10/13/2006
Last updated
09/02/2008
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