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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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