Adcock, Jack Tyrone
Adcock, Jack Tyrone is an individual health care provider with primary practice located at 3401 Mcintosh Cir Ste 200 , Joplin MO 64804-3604. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Adcock, Jack Tyrone can be contacted via phone (417) 347-3703.Contact Information
Primary practice address
3401 Mcintosh Cir Ste 200
Joplin MO 64804-3604
Phone: (417) 347-3703
Fax: (417) 347-3727
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 2001025553 | Missouri |
Profile Details
| NPI number | 1669487054 |
|---|---|
| LBN Legal business name | Adcock, Jack Tyrone |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Mar 18th, 2024 - about 9 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669487054 | NPPES |
| Missouri | MEDICAID | 245800602 |
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