Individual
DR. LAWRENCE L. DYBEDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10763 HIGHWAY 39, STE. 200, MOUNT VERNON, MO 65712-7823
(417) 269-2460
(417) 269-2462
Mailing address
PO BOX 505673, SAINT LOUIS, MO 63150-5673
(417) 730-6430
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2004036071
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208386904
—
MO
Enumeration date
08/30/2006
Last updated
07/11/2024
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