Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 36065 | MO |
NPI | 1053429977 |
---|---|
Provider Name | John Best |
First Address | Chesterfield, MO 63017-3625 |
Second Address | Chesterfield, MO 63017-3625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 15/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A25184 | (02) | MO |