Provider Demographics
NPI:1689634818
Name:BOYCE & BYNUM PATHOLOGY PROFESSIONAL SERVICES INC
Entity Type:Organization
Organization Name:BOYCE & BYNUM PATHOLOGY PROFESSIONAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:573-886-4600
Mailing Address - Street 1:300 PORTLAND ST STE 110
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-7390
Mailing Address - Country:US
Mailing Address - Phone:573-886-4600
Mailing Address - Fax:573-886-4695
Practice Address - Street 1:300 PORTLAND ST STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-7390
Practice Address - Country:US
Practice Address - Phone:573-886-4600
Practice Address - Fax:573-886-4695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO26D0652373207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
199076OtherBLUE CROSS BLUE SHIELD
MO500595806Medicaid
AR126819002Medicaid
000010984Medicare PIN
CN9822Medicare PIN