NPI 1033229935

William Russell Detten, DO

Practitioner Family Medicine Physician Springfield, MO

Practice location

Address: 1530 E Republic Rd, Springfield, MO 65804-6530
Phone: (417) 269-1362
Fax: (417) 269-1372
Mailing address: PO Box 4046, Springfield, MO 65808-4046

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence R4P90 (MO)

Other Family Medicine providers in Missouri →

Registry record

NPI: 1033229935
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Aug 2006
Record last updated: 12 Nov 2012

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.