Basic Information
Provider Information
NPI: 1699330324
EntityType: 2
ReplacementNPI:  
OrganizationName: URGENT CARE OF MISSOURI
LastName:  
FirstName:  
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NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 6966 S UTICA AVE STE 225
Address2:  
City: TULSA
State: OK
PostalCode: 741363903
CountryCode: US
TelephoneNumber: 8554926333
FaxNumber:  
Practice Location
Address1: 1721 LA QUESTA DR STE 5
Address2:  
City: NEOSHO
State: MO
PostalCode: 648509000
CountryCode: US
TelephoneNumber: 8554926333
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/08/2019
LastUpdateDate: 05/08/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SHAKEEL
AuthorizedOfficialFirstName: AZHAR
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 9186860400
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QU0200X  Y Ambulatory Health Care FacilitiesClinic/CenterUrgent Care

No ID Information.


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