Provider Demographics
NPI:1104845783
Name:WINDSOR, BRICE P (DO)
Entity Type:Individual
Prefix:
First Name:BRICE
Middle Name:P
Last Name:WINDSOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:2613 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-4030
Practice Address - Country:US
Practice Address - Phone:573-642-1990
Practice Address - Fax:573-642-5089
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2005013510207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207278904Medicaid
MOI35689Medicare UPIN
MO932833048Medicare PIN