| NPI | 1073519898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA S DODGE Practice Administrator 573-499-0642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2023-10-31 |