Provider Demographics
NPI:1205880549
Name:CAGLE, ROBERT DALE (DO)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DALE
Last Name:CAGLE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1500 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-3011
Mailing Address - Country:US
Mailing Address - Phone:417-326-6000
Mailing Address - Fax:417-328-6338
Practice Address - Street 1:1245 N BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-3017
Practice Address - Country:US
Practice Address - Phone:417-328-7702
Practice Address - Fax:417-777-7881
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2015-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2005007763207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA10702Medicare UPIN
138880010Medicare Oscar/Certification