Basic Information
| Provider Information | |||||||||
| NPI: | 1417035353 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DEBORAH D PRICE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3250 GORDONVILLE RD | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | CAPE GIRARDEAU | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637035056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733319641 | ||||||||
| FaxNumber: | 5733313120 | ||||||||
| Practice Location | |||||||||
| Address1: | 1701 LACEY ST | ||||||||
| Address2: | |||||||||
| City: | CAPE GIRARDEAU | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637015230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733349641 | ||||||||
| FaxNumber: | 5733313120 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SCHWETTMAN | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | INSURANCE/BILLING | ||||||||
| AuthorizedOfficialTelephone: | 5733349641 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | DOR3P08 | MO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.