Provider Demographics
NPI:1952646184
Name:EMERGENCY PHYSICIANS OF SPRINGFIELD, INC
Entity Type:Organization
Organization Name:EMERGENCY PHYSICIANS OF SPRINGFIELD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAWYERS
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-B, CCS, CPC
Authorized Official - Phone:417-269-6583
Mailing Address - Street 1:4121 S FREMONT AVE
Mailing Address - Street 2:SUITE 120 BOX 205
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-6535
Mailing Address - Country:US
Mailing Address - Phone:417-269-6583
Mailing Address - Fax:417-269-6573
Practice Address - Street 1:1423 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-1917
Practice Address - Country:US
Practice Address - Phone:417-269-6583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001018430363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty