SOUTHWEST MISSOURI INFECTIOUS DISEASE LLC (NPI# 1396284303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396284303 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST MISSOURI INFECTIOUS DISEASE LLC |
| Practice Address |
2872 S Forrest Heights Ave Springfield MO 65809-3417 |
| Practice Telephone | 4174591711 |
| Mailing Telephone | 4174591711 |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2017-02-23 |
| Authorized Official Name | DR. ERIC JEROME FULNECKY (OWNER) |
| Authorized Official Telephone | 4174591711 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
2004006990 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
2872 S FORREST HEIGHTS AVE |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65809-3417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073016671 | Luke P Walker | Pharmacist | 1247 S Greentree Ave, Springfield, MO 65809 | 2018-03-10 |
| 1265985543 | Stacy Loc Rohrbaugh | Registered Nurse | 889 White Diamond Ct, Springfield, MO 65809 | 2016-08-03 |
| 1144651571 | Valence Massage | Massage Therapist | 4411 E. Sunshine, Suite H, Springfield, MO 65809 | 2013-12-11 |
| 1750654752 | Leo Thomas Neu Jr. | Internal Medicine | 3721 E Bowman, Springfield, MO 65809 | 2012-02-22 |
| 1194743187 | Daniel Joseph Edwards | Specialist/Technologist | 807 S Mission Cir, Springfield, MO 65809-1348 | 2006-07-17 |
| 1780892976 | The Arc of The Ozarks | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3445 E Lombard St, Springfield, MO 65809-1420 | 2007-05-19 |
| 1093189953 | Henry Krahn | Community Health Worker | 741 S Mumford Cir, Springfield, MO 65809-1516 | 2015-11-16 |
| 1366683989 | Nancy Louise Samples | Counselor | 4410 E Valley Rd, Springfield, MO 65809-1622 | 2009-03-11 |
| 1558902775 | Stephanie L Mcbratney | Speech-Language Pathologist | 3510 E Whitehall Dr, Springfield, MO 65809-2135 | 2019-09-30 |
| 1508992686 | Raystarr, LLC | Durable Medical Equipment & Medical Supplies | 3259 E Sunshine St Ste R, Springfield, MO 65809-2143 | 2007-02-26 |
| Find all providers in zip 65809 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548524218 | Blessy John | Internal Medicine | 2115 S Fremont Ave Ste 3050, Springfield, MO 65804-2236 | 2012-06-27 |
| 1588685986 | Nhat M. Doan | Internal Medicine | 6501 Loisdale Ct Fl 6, Kaiser Permanente Springfield Medical Center, Springfield, VA 22150-1826 | 2006-07-21 |
| 1609834662 | Claudia T Martorell | Internal Medicine | 57 Mulberry St., Springfield, MA 01105 | 2006-05-01 |
| 1497756092 | Robert Philip Hoffman | Internal Medicine | 300 Stafford St, Suite 306, Springfield, MA 01104-3581 | 2005-08-03 |
| 1124401070 | Zainab Alnafoosi | Internal Medicine | 751 N Rutledge St, Springfield, IL 62702-4968 | 2015-07-09 |
| 1700268216 | Lyndsey Heise | Internal Medicine | 900 N 1st St, Springfield, IL 62702-3749 | 2015-06-19 |
| 1295172344 | Jacob M Smith | Internal Medicine | 3300 Main Street, 3rd Fl, Suite C&d, Springfield, MA 01107 | 2013-05-30 |
| 1114284890 | Megan Carol Gallagher | Internal Medicine | 3300 Main St Fl 3, Springfield, MA 01107-1112 | 2012-04-18 |
| 1730446535 | Megan D. Edwards | Internal Medicine | 11 Wilbraham Rd, Springfield, MA 01109 | 2012-04-18 |
| 1629361829 | Maria Catalina Merrick | Internal Medicine | 900 N 1st St, Springfield, IL 62702-3749 | 2011-05-20 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65809 |
Please comment or provide details below to improve the information on SOUTHWEST MISSOURI INFECTIOUS DISEASE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.