Provider Demographics
NPI:1942392949
Name:LESTER E COX MEDICAL CENTERS
Entity Type:Organization
Organization Name:LESTER E COX MEDICAL CENTERS
Other - Org Name:COX HEALTH CENTER OZARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-269-6262
Mailing Address - Street 1:3800 S NATIONAL AVE
Mailing Address - Street 2:#540
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5209
Mailing Address - Country:US
Mailing Address - Phone:417-269-6262
Mailing Address - Fax:417-269-4349
Practice Address - Street 1:506 E SOUTH ST
Practice Address - Street 2:EVANS PLAZA
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-8571
Practice Address - Country:US
Practice Address - Phone:417-269-2215
Practice Address - Fax:417-269-2427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO500020805Medicaid
197575OtherBLUE CROSS OF MO
197575OtherBLUE CROSS OF MO
MO000014554Medicare PIN