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Contact Information

MEDICAL & SURGICAL SPECIALISTS OF ROLLA, INC.
600 BLUES LAKE PKWY
ROLLA, MO65401-8022
 Phone: 573-364-8822
 Fax: 573-341-5969
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
 

Otolaryngic Allergy

207YX0602X 04 Physician/Otolaryngology
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Podiatrist

213E00000X 48 Podiatry
 

Surgery

208600000X 02 Physician/General Surgery
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MEDICAL & SURGICAL SPECIALISTS OF ROLLA, INC.

NPI Number 1376560383
LBN Legal business name MEDICAL & SURGICAL SPECIALISTS OF ROLLA, INC.
Authorized official RICHARD KRENNING - (CHIEF OPERATING OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/16/2006
Last updated 07/03/2008 - About 18 years ago
Identifiers
MO Medicaid 503052706
GA Other DA5531 RAIL ROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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