Provider Demographics
NPI:1417035353
Name:DEBORAH D PRICE
Entity Type:Organization
Organization Name:DEBORAH D PRICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE/BILLING
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWETTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-334-9641
Mailing Address - Street 1:3250 GORDONVILLE RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-5056
Mailing Address - Country:US
Mailing Address - Phone:573-331-9641
Mailing Address - Fax:573-331-3120
Practice Address - Street 1:1701 LACEY ST
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-5230
Practice Address - Country:US
Practice Address - Phone:573-334-9641
Practice Address - Fax:573-331-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODOR3P08207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty