Organization
LESTER E. COX MEDICAL CENTERS
Active
Other names
NEONATOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID P TAYLOR (VICE PRESIDENT)
(417) 269-6262
Entity
Organization
Contact information
Practice address
1000 E PRIMROSE ST, #140, SPRINGFIELD, MO 65807-5154
(417) 269-6184
(417) 269-4608
Mailing address
3800 S NATIONAL AVE, #540, SPRINGFIELD, MO 65807-5209
(417) 269-6262
(417) 269-4349
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
148059002
ARKANSAS MEDICAID
AR
01
—
201672
BLUE CROSS OF MO
—
05
—
500786603
—
MO
Enumeration date
10/13/2006
Last updated
06/20/2008
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