NPI | 1154838209 |
---|---|
Doing Business As | OZARKS HEALTHCARE PEDIATRICS |
Entity Type | Organization |
Authorized Contact | BARRYLYN ULMANIS Provider Enrollment Coordinator 417-257-6792 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics |
Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: MO 174-59) |
Enumeration Date | 2018-01-10 |
Last Update Date | 2020-11-12 |