JEFFERSON CITY OBSTETRICS & GYNECOLOGY INC NPI 1235311796

NPI Information

JEFFERSON CITY OBSTETRICS & GYNECOLOGY INC is an obstetrics gynecology in Jefferson City, MO. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. JEFFERSON CITY OBSTETRICS & GYNECOLOGY INC NPI is 1235311796. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2712 PLAZA DR
JEFFERSON CITY, MO
ZIP 65109-147
Phone: (573) 893-5500

The provider's authorized official is Kwei Lee Su .
The authorized official title is Administrator and has the following contact phone number (573) 893-5500.

The CLIA number assigned to this NPI record is 26D0446124 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/27/2007 and was last updated on 4/6/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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