Provider Demographics
NPI:1780639799
Name:MEXICO MEDICAL SPECIALISTS, L.C.
Entity Type:Organization
Organization Name:MEXICO MEDICAL SPECIALISTS, L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:NORVIN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:573-581-8500
Mailing Address - Street 1:600 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:MO
Mailing Address - Zip Code:65265-3724
Mailing Address - Country:US
Mailing Address - Phone:573-581-8500
Mailing Address - Fax:573-581-5397
Practice Address - Street 1:600 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-3724
Practice Address - Country:US
Practice Address - Phone:573-581-8500
Practice Address - Fax:573-581-5397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty