Provider Demographics
NPI:1255470878
Name:JAMES J CESAR DO
Entity Type:Organization
Organization Name:JAMES J CESAR DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:CESAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:417-334-5171
Mailing Address - Street 1:PO BOX 8516
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65801-8516
Mailing Address - Country:US
Mailing Address - Phone:417-864-5455
Mailing Address - Fax:417-864-5781
Practice Address - Street 1:101 SKAGGS RD
Practice Address - Street 2:SUITE 303
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2075
Practice Address - Country:US
Practice Address - Phone:417-334-5171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105484261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO8964OtherBLUE SHIELD NON-PART
MO8964OtherBLUE SHIELD NON-PART
MODC0639Medicare ID - Type UnspecifiedRAILROAD MEDICARE