Jefferson City Obstetrics & Gynecology Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

119368 Issued in MO

Legal business name

JEFFERSON CITY OBSTETRICS & GYNECOLOGY INC

Practice address

2712 Plaza Dr
Jefferson City, MO 65109-1147

Phone

(573) 893-5500

NPI assigned

Nov 27, 2007

Last updated

Apr 6, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kwei Lee Su, PHD

Title

Administrator

Phone

(573) 893-5500

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1235311796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 PLAZA DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 PLAZA DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651091147",
            "telephone_number": "573-893-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON CITY OBSTETRICS & GYNECOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "SU",
        "authorized_official_first_name": "KWEI",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-893-5500",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "119368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jefferson City Medical Group, PC (Express Care of JCMG)
• Jefferson City Medical Group, PC (JCMG Path Lab)
• Jefferson City Medical Group, PC (JCMG Anesthesia)
• Jefferson City Medical Group, PC
• Jefferson City Nursing and Rehabilitation Center, LLC
• Jefferson City Open MRI LLC
• Jefferson City Oral and Maxillofacial Surgery, LLC
• Jefferson City Public Schools
• Jefferson City Renal Services LLC
• Jefferson City Renal Services LLC

• Obstetrics & Gynecology Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.