Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 2005019382 | MO |
NPI | 1003829078 |
---|---|
Provider Name | Janel M Ochse |
First Address | Springfield, MO 65804-2203 |
Second Address | Springfield, MO 65804-2203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 13/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I35307 | (02) |