Level 4 Medical Professional Corporation

NPI #1861706434 in Stockton, Missouri

Provider Information

NPI Number: 1861706434
Entity Type: Organization
Organization Name: Level 4 Medical Professional Corporation
Primary Specialty: Point of Service
Enumeration Date: Aug 5, 2010
Last Updated: Jan 29, 2015

Practice Location

Address: 913 SOUTH ST
City: Stockton
State: Missouri
ZIP Code: 65785-9381
Phone: (417) 809-8620

Authorized Official

Name: DAVID E SMOCK, MD
Title: OWNER
Phone: (928) 503-4261

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Point of Service	305S00000X	Primary

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