Provider Demographics
NPI:1780647164
Name:PARKVIEW SURGEONS, PC
Entity Type:Organization
Organization Name:PARKVIEW SURGEONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER OR CORPORATION
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILHOLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:417-326-2100
Mailing Address - Street 1:1300 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-3018
Mailing Address - Country:US
Mailing Address - Phone:417-326-2100
Mailing Address - Fax:417-777-6677
Practice Address - Street 1:1300 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-3018
Practice Address - Country:US
Practice Address - Phone:417-326-2100
Practice Address - Fax:417-777-6677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001029380208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MODC4673OtherRAILROAD MEDICARE