Provider Demographics
NPI:1023055605
Name:BROWNFIELD, MONA L (MD)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:L
Last Name:BROWNFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:516 JACKSON RD
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:MO
Practice Address - Zip Code:65233-2845
Practice Address - Country:US
Practice Address - Phone:660-882-3585
Practice Address - Fax:660-882-3709
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO115431207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205336100Medicaid
MO80173490OtherRAILROAD MEDICARE
MO143535OtherBLUE CHOICE
MO205336100Medicaid
MO458562OtherHEALTHLINK
MO80173490OtherRAILROAD MEDICARE
MOH40401Medicare UPIN