Groshong, Ted

Groshong, Ted is an individual health care provider with primary practice located at 402 N Keene St Ste 101, Columbia MO 65201-6986. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Groshong, Ted can be contacted via phone (573) 882-6921.

Contact Information

Primary practice address
402 N Keene St Ste 101 Columbia MO 65201-6986
Phone: (573) 882-6921
Fax: (573) 882-1154
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD31289 Missouri

Profile Details

NPI number 1881649754
LBN Legal business name Groshong, Ted
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Aug 16th, 2011 - about 13 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 1881649754 NPPES
Arkansas Other 140113001 ARKANSAS MEDICAID
Arkansas Other 3730 ARKANSAS MEDICAID
Arkansas Other 7509311 ARKANSAS MEDICAID
Arkansas Other 102486 ARKANSAS MEDICAID
Arkansas MEDICAID 200528107 ARKANSAS MEDICAID
Arkansas Other 2086349901 ARKANSAS MEDICAID

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