Fancher, Michael R

Fancher, Michael R is an individual health care provider with primary practice located at 3801 S National Ave , Springfield MO 65807-5210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Fancher, Michael R can be contacted via phone (417) 269-4056.

Contact Information

Primary practice address
3801 S National Ave Springfield MO 65807-5210
Fax: (417) 269-5556
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X R8G08 Missouri

Profile Details

NPI number 1003876681
LBN Legal business name Fancher, Michael R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Sep 4th, 2009 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003876681 NPPES
Arkansas MEDICAID 160278001
Arkansas Other 300120714
Arkansas Other 1256
Arkansas MEDICAID 203056072

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