Individual
ARMANDO R FAVAZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5111
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5111
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R4884
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102461
HEALTHLINK
MO
01
—
1545500
UNITED HEALTHCARE
MO
05
—
200465805
—
MO
01
—
2086351501
KANSAS MEDICAID
MO
01
—
3052
BLUE CHOICE/BLUE SHIELD
MO
Enumeration date
05/02/2006
Last updated
03/11/2020
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