Provider Demographics
NPI:1811199300
Name:INTERNAL MEDICINE ASSOCIATES OF JOPLIN P.C.
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES OF JOPLIN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CASCONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:417-624-0200
Mailing Address - Street 1:2700 MC CLELLAND BLVD
Mailing Address - Street 2:BUILDING B SUITE 201
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1623
Mailing Address - Country:US
Mailing Address - Phone:417-624-0200
Mailing Address - Fax:417-624-0220
Practice Address - Street 1:2700 MC CLELLAND BLVD
Practice Address - Street 2:BUILDING B SUITE 201
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1623
Practice Address - Country:US
Practice Address - Phone:417-624-0200
Practice Address - Fax:417-624-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111220207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOT15E076Medicare ID - Type UnspecifiedMRE OF KANSAS CITY, MO