Provider Demographics
NPI:1033106661
Name:HONEYCUTT, PAMELA J (MD PHD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:HONEYCUTT
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1705 E BROADWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-5852
Mailing Address - Country:US
Mailing Address - Phone:573-874-7800
Mailing Address - Fax:573-443-3627
Practice Address - Street 1:1705 E BROADWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-5852
Practice Address - Country:US
Practice Address - Phone:573-874-7800
Practice Address - Fax:573-443-3627
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR2K75207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
28122OtherGHP
5132415OtherAETNA
106098OtherBCBS OF MO
252892OtherHEALTHLINK
3604007OtherUNITED HEALTHCARE
C84562OtherMERCY HEALTH PLANS
MO202781209Medicaid
65201A010OtherTRICARE
C84562OtherMERCY HEALTH PLANS
252892OtherHEALTHLINK
MO202781209Medicaid
MOMA1231002Medicare PIN