Provider Demographics
NPI:1124567623
Name:CURATORS OF THE UNIVESITY OF MISSOURI
Entity Type:Organization
Organization Name:CURATORS OF THE UNIVESITY OF MISSOURI
Other - Org Name:UNIVERSITY PHYSICIANS SPECIALTY CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOEBELIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-884-1753
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 1:1000 W NIFONG BLVD
Practice Address - Street 2:BLDG 7, STE 300
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-5615
Practice Address - Country:US
Practice Address - Phone:573-884-1130
Practice Address - Fax:573-884-5936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO550565402Medicaid
MO000015236Medicare PIN