Basic Information
| Provider Information | |||||||||
| NPI: | 1356342570 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRUEBLOOD | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | CLARKE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 BIENVILLE AVE | ||||||||
| Address2: | ORTHOPAEDIC ASSOCIATES OF SOUTHEAST MISSOURI PC | ||||||||
| City: | CAPE GIRARDEAU | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637011944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733358257 | ||||||||
| FaxNumber: | 5733358424 | ||||||||
| Practice Location | |||||||||
| Address1: | 48 DOCTORS PARK | ||||||||
| Address2: | ORTHOPAEDIC ASSOCIATES OF SOUTHEAST MISSOURI PC | ||||||||
| City: | CAPE GIRARDEAU | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637034928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733358257 | ||||||||
| FaxNumber: | 5733358424 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 01/14/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | R8424 | MO | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.