NPI 1326386509

Nathan a Miracle, PAC

Practitioner Surgical Physician Assistant Ozark, MO

Practice location

Address: 3050 E River Bluff Blvd, Ozark, MO 65721
Phone: (417) 820-5610
Mailing address: 3050 E River Bluff Blvd, Ozark, MO 65721-8807

Registered specialties

Surgical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence 2013001193 (MO)

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Registry record

NPI: 1326386509
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jan 2013
Record last updated: 19 Jul 2018

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.