Provider Demographics
NPI:1104829282
Name:CANTRELL, SIDNEY ALLEN RHEA (DO)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:ALLEN RHEA
Last Name:CANTRELL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2101 CORONA RD
Mailing Address - Street 2:STE 102
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2582
Mailing Address - Country:US
Mailing Address - Phone:573-234-1800
Mailing Address - Fax:573-234-1799
Practice Address - Street 1:2101 CORONA RD
Practice Address - Street 2:STE 102
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2582
Practice Address - Country:US
Practice Address - Phone:573-234-1800
Practice Address - Fax:573-234-1799
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2022-12-05
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Provider Licenses
StateLicense IDTaxonomies
MOR9D24207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO45797OtherFIRST HEALTH
MO5824126001OtherCIGNA
MO300200OtherFAMILY HEALTH PARTNERS
MO1104829282OtherCOMMUNITY HEALTH PLAN
MO268352OtherCOVENTRY HEALTHCARE OF KC
MO10867027OtherBCBSKC PROVIDER
MO242095230Medicaid
MO710918160OtherGREAT WEST HEALTHPLANS
MO710918160OtherBEECH STREET
MO710918160OtherUNITED HEALTHCARE
MO710918160OtherAETNA
MO10867027OtherBCBSKC PROVIDER
MO710918160OtherBEECH STREET
MOC50465Medicare UPIN