Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | R2K75 | MO |
NPI | 1033106661 |
---|---|
Provider Name | Pamela J Honeycutt |
First Address | Columbia, MO 65201-5852 |
Second Address | Columbia, MO 65201-5852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 10/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
106098 | BCBS OF MO (01) | |
202781209 | (05) | MO |
252892 | HEALTHLINK (01) | |
28122 | GHP (01) | |
3604007 | UNITED HEALTHCARE (01) | |
5132415 | AETNA (01) | |
65201A010 | TRICARE (01) | |
C84562 | (02) | |
C84562 | MERCY HEALTH PLANS (01) |