Pediatrics – Pediatrics Physician, NPI 1689614646
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Pediatrics
PO BOX 104240
JEFFERSON CITY, MO 651104240
Phone: (573) 635-5264
Fax: (573) 636-9756
Type: Mailing
1241, West Stadium Boulevard, Jefferson City, Cole County, Missouri, 65109, United States
FIRST FLOOR, SUITE 1300
JEFFERSON CITY, MO 651096023
Phone: (573) 556-5747
Fax: (573) 636-9756
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 65110)
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