Provider Demographics
NPI:1295707693
Name:FINNEY, JAN (DO)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:
Last Name:FINNEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 BUCHANAN
Mailing Address - Street 2:HWY 50 W, CAPITAL REGION MEDICAL CLINIC CALIFORNIA
Mailing Address - City:CALIFORNIA
Mailing Address - State:MO
Mailing Address - Zip Code:65018
Mailing Address - Country:US
Mailing Address - Phone:573-796-3111
Mailing Address - Fax:573-796-3042
Practice Address - Street 1:704 BUCHANAN
Practice Address - Street 2:HWY 50 W
Practice Address - City:CALIFORNIA
Practice Address - State:MO
Practice Address - Zip Code:65018
Practice Address - Country:US
Practice Address - Phone:573-796-3111
Practice Address - Fax:573-796-3042
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5H49208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
14428OtherBLUE CROSS BLUE SHIELD
141791OtherHEALTHLINK
79896OtherFIRST HEALTH
8173161OtherCIGNA
D41771OtherMERCY
080145024OtherRR MEDICARE
MO242507820Medicaid
440546366OtherUNITED HEALTHCARE
8173161OtherCIGNA
440546366OtherUNITED HEALTHCARE