Basic Information
| Provider Information | |||||||||
| NPI: | 1679510358 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AZELTON | ||||||||
| FirstName: | RONDA | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3800 S. NATIONAL AVE | ||||||||
| Address2: | STE. 540 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658075209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4173541500 | ||||||||
| FaxNumber: | 4173541505 | ||||||||
| Practice Location | |||||||||
| Address1: | 815 N. LINCOLN | ||||||||
| Address2: | #G | ||||||||
| City: | MONETT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 657081641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4173541500 | ||||||||
| FaxNumber: | 4173541505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 05/14/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036.123755 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2010026539 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.