Individual
CHADRON VASSAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
1100 N KENTUCKY AVE, WEST PLAINS, MO 65775-2029
(417) 256-9111
Mailing address
1100 N KENTUCKY AVE, WEST PLAINS, MO 65775-2029
(417) 256-9111
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
19119
ND
207L00000X
Anesthesiology Physician
Primary
2021044086
MO
207L00000X
Anesthesiology Physician
84627
MT
207L00000X
Anesthesiology Physician
DO-05137
IA
207L00000X
Anesthesiology Physician
DO3213
ME
207LP3000X
Pediatric Anesthesiology Physician
DO-05137
IA
Other
Enumeration date
04/07/2015
Last updated
09/24/2025
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