Provider Demographics
NPI:1972630085
Name:TENORIO, ARTURO A (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTURO
Middle Name:A
Last Name:TENORIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:MO
Mailing Address - Zip Code:64402-1433
Mailing Address - Country:US
Mailing Address - Phone:660-726-3941
Mailing Address - Fax:
Practice Address - Street 1:705 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:MO
Practice Address - Zip Code:64402-1433
Practice Address - Country:US
Practice Address - Phone:660-726-3941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8525207Q00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO07878056OtherBCBS
MO200862316Medicaid
MO10001267400OtherCOMMUNITY HEALTH PLAN
MOK784128Medicare ID - Type Unspecified
MO07878056OtherBCBS