Provider Demographics
NPI:1255315289
Name:RIGHTS, THEODORE H (MD)
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:H
Last Name:RIGHTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1600 E EVERGREEN ST
Mailing Address - Street 2:PO BOX 557
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-2400
Mailing Address - Country:US
Mailing Address - Phone:816-632-2101
Mailing Address - Fax:816-649-3383
Practice Address - Street 1:212 N DAVIS ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MO
Practice Address - Zip Code:64644-1143
Practice Address - Country:US
Practice Address - Phone:816-583-7839
Practice Address - Fax:816-583-7842
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2010-12-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO106787207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO930021603OtherMEDICARE RAILROAD
MO7857433OtherMEDICARE PART B
MO206021008Medicaid
MOB34926Medicare UPIN