PLASTIC SURGERY & WEIGHT LOSS CNTR (NPI# 1699961193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699961193 |
| Entity Type | Organization |
| Organization Name | PLASTIC SURGERY & WEIGHT LOSS CNTR |
| Practice Address |
10994 Historic Highway 165 Ste D Hollister MO 65672-5606 |
| Mailing Address |
Po Box 8781 Springfield MO 65801-8781 |
| Practice Telephone | 4172390079 |
| Practice Fax Number | 4172391228 |
| Mailing Telephone | 4172390079 |
| Mailing Fax Number | 4172391228 |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2013-04-16 |
| Authorized Official Name | DR. MARIAN W STEWART (OFFICER) |
| Authorized Official Telephone | 4172390079 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
101644 | MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | BLUE SHIELD OF KC | 21186039 | 01 |
| MO | BLUE SHIELD NON-PART | 10014M | 01 |
| MO | RAILROAD MEDICARE | DD0320 | 01 |
| MO | 244744504 | 05 |
| Street Address |
10994 HISTORIC HIGHWAY 165 STE D |
| City | HOLLISTER |
| State | MO |
| Zip Code | 65672-5606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518911676 | Marian W Stewart | Surgery | 10994 Historic Highway 165 Ste D, Hollister, MO 65672-5606 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760992994 | Lajan Kayle Taylor | Speech-Language Pathologist | 11103 Historic Hwy. 165, Hollister, MO 65672 | 2017-10-02 |
| 1417094087 | Canote Pharmacy, Inc | Pharmacy | 215 Gage Drive, Suite L, Hollister, MO 65672 | 2007-01-31 |
| 1538247887 | Skaggs Community Hospital Association | Pediatrics | 590 Birch Street, Ste 2c, Hollister, MO 65672 | 2006-11-02 |
| 1396797585 | Christopher S Fletcher | Family Medicine | 10994 Historic Hwy 165, Hollister, MO 65672 | 2006-05-16 |
| 1366443962 | Johnny Lee Gillispie | Internal Medicine | 590 Birch Rd, Ste 1b, Hollister, MO 65672 | 2005-08-03 |
| 1154508752 | Woman's Clinic of Branson, LLC | Obstetrics & Gynecology | 590 Birch Rd, Suite 2-b, Hollister, MO 65672 | 2008-01-25 |
| 1164561148 | Canote Pharmacy, Inc | Pharmacy | 215 Gage Drive, Suite K, Hollister, MO 65672 | 2007-02-06 |
| 1316373145 | Toni D Mcclure | Social Worker | 115 Deep Forrest, Hollister, MO 65672-4104 | 2013-09-25 |
| 1548365448 | R Randall Sukman | Internal Medicine | 2331 S Business Highway 65, Hollister, MO 65672-5105 | 2006-09-14 |
| 1629230826 | Lionheart Holdings, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2331 S Business Highway 65, Hollister, MO 65672-5105 | 2008-06-28 |
| Find all providers in zip 65672 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536818 | Heartland Weight Loss Clinic, LLC | Clinic/Center | 3095 Lexington Ave Ste 200, Cape Girardeau, MO 63701-2629 | 2020-10-23 |
| 1902361652 | Redings Mill Internal Care | Clinic/Center | 454 Redings Mill Rd, Joplin, MO 64804 | 2019-02-06 |
| 1386126308 | Kirksville Specialty Clinic LLC | Clinic/Center | 1108 E Patterson St Ste 10, Kirksville, MO 63501-4043 | 2018-09-06 |
| 1639616113 | Stratus Medical Group | Clinic/Center | 2010 N Main St, Sikeston, MO 63801-8478 | 2017-01-23 |
| 1871044735 | Susan D Purcell Md Dermatology LLC | Clinic/Center | 969 N Mason Rd Ste 170, Saint Louis, MO 63141-6387 | 2016-10-16 |
| 1679961577 | Ssm Regional Health Services | Clinic/Center | 2505 Mission Dr Ste 130, Jefferson City, MO 65109-9508 | 2014-12-30 |
| 1407251069 | Missouri Cvs Pharmacy, L.L.C. | Clinic/Center | 942 Valley Creek Dr, Farmington, MO 63640-1968 | 2014-10-24 |
| 1154730414 | Mohammed Z Siddiqui Medical Consulting LLC | Clinic/Center | 10 Overbrook Dr, Saint Louis, MO 63124-1482 | 2014-08-11 |
| 1962818435 | Retired | Clinic/Center | 13714 N Sportsmans Dr, Hallsville, MO 65255-9330 | 2014-07-06 |
| 1043625460 | Kobler Chiropractic and Acupuncture LLC | Clinic/Center | 500 Nw Englewood Rd, Kansas City, MO 64118-3960 | 2014-06-24 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PLASTIC SURGERY & WEIGHT LOSS CNTR.
| 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.