Individual
PAUL ELLIS ANDREWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2600
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R7G74
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110081857
TRAVELERS MCR
—
05
—
125807001
—
AR
01
—
126814
BCBS
—
05
—
1982640694
—
MO
01
—
250766
HEALTHLINK
—
01
—
431560263
TRICARE
MO
01
—
82055
AR BLUE SHIELD
AR
01
—
P00333595
RR MCR
MO
Enumeration date
06/21/2006
Last updated
10/08/2014
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