Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QS0010X | Family Doctor - Sports Medicine | 0434967 | KS |
Y | 207QS0010X | Family Doctor - Sports Medicine | 2010011161 | MO |
NPI | 1134191257 |
---|---|
Provider Name | Dr. Alexander William Schoofs |
First Address | Platte City, MO 64079-7707 |
Second Address | Platte City, MO 64079-7707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 27/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
204923100 | (05) | MN |
P00746333 | MEDICARE, RAILROAD (01) | MN |