NPI 1164545315

Specialty Surgical Services

Organisation Surgery Physician Columbia, MO

Practice location

Address: 3115 Falling Leaf CT, Columbia, MO 65201-3579
Phone: (573) 449-5000
Fax: (573) 449-5010

Authorised official

Name: Matthew J Concannon
Title: Owner
Phone: (573) 449-5000

Registered specialties

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence MDR7H73 (MO)

Other Surgery providers in Missouri →

Registry record

NPI: 1164545315
Entity type: Organization
NPI issued: 10 Apr 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.