Provider Demographics
NPI:1407913833
Name:PARTON, JUDY M (MD)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:M
Last Name:PARTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:K
Other - Last Name:MUNYON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:148 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIBERAL
Mailing Address - State:MO
Mailing Address - Zip Code:64762-9314
Mailing Address - Country:US
Mailing Address - Phone:417-843-2008
Mailing Address - Fax:417-843-2010
Practice Address - Street 1:148 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LIBERAL
Practice Address - State:MO
Practice Address - Zip Code:64762-9314
Practice Address - Country:US
Practice Address - Phone:417-843-2008
Practice Address - Fax:417-843-2010
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7546207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202065207Medicaid
MO9001B18442OtherCHAMPUS
B18442Medicare UPIN
MO202065207Medicaid