Organization · NPI-2

417 Rheumatology LLC

Internal Medicine, Rheumatology · Springfield, MO

NPI number1902448426
StatusActive
Last updated in NPPESJun 27, 2022

Details

NPI
1902448426
Entity type
Organization (NPI-2)
Legal business name
417 Rheumatology LLC
Organization subpart
No
Enumeration date
Oct 16, 2019
Certification date
Jun 27, 2022
Last updated
Jun 27, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RR0500X Internal Medicine, Rheumatology––Yes

Practice location

909 E Republic Rd Ste D200
Springfield, MO 65807-6012

Phone 417-501-2644

Mailing address

909 E Republic Rd Ste D200
Springfield, MO 65807-6012

Phone 417-501-2644

Authorized official

Ryan Cady
Managing Partner
4175012644

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