Dominguez, Jose M
Dominguez, Jose M is an individual health care provider with primary practice located at 1001 E Primrose St , Springfield MO 65807-5155. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Dominguez, Jose M can be contacted via phone (417) 875-3276.Contact Information
Primary practice address
1001 E Primrose St
Springfield MO 65807-5155
Phone: (417) 875-3276
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | 107891 | Missouri |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 107891 | Missouri |
Profile Details
| NPI number | 1295773927 |
|---|---|
| LBN Legal business name | Dominguez, Jose M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 3rd, 2006 |
| Last updated | Jul 21st, 2022 - about 3 years 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 | 1295773927 | NPPES |
| Other | 106986 | BLUE CROSS/BLUE SHIELD | |
| MEDICAID | 207976002 | BLUE CROSS/BLUE SHIELD |
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