| NPI | 1366946832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WRIGHT MOUNTJOY Administrator 573-499-6540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| 207RR0500X Internal Medicine Rheumatology | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2022-07-15 |