Provider Demographics
NPI:1326031915
Name:FRONCEK, JAMES C (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:FRONCEK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-269-5712
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:960 E. WALNUT LAWN STREET STE 201
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807
Practice Address - Country:US
Practice Address - Phone:417-269-4450
Practice Address - Fax:417-269-8333
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006025309207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1326031915Medicaid
P00852006OtherRAILROAD MEDICARE GROUP CB9013
AR183186003Medicaid
431560263OtherTRICARE WEST
MO201460706Medicaid
MOP00363136OtherRAILROAD MEDICARE
AR183186003Medicaid
MOP00363136OtherRAILROAD MEDICARE
MO960553557Medicare PIN