Boone Physician Services, LLC
Organization Active NPI Surgery Physician · Columbia, MO
NPI 1295699486 · NPPES record last updated Dec 11, 2025
Key facts
- NPI
- 1295699486
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- BOONE PHYSICIAN SERVICES, LLC
- Practice address
- 1605 E Broadway Ste 200
Columbia, MO 65201-8023 - Phone
- (573) 815-8000
- NPI assigned
- Dec 11, 2025
- Organization subpart
- Yes
- Parent organization (as reported)
- BOONE PHYSICIAN SERVICES, LLC
Authorized official
- Name
- Edward James Clayton Jr.
- Title
- Chief Financial Officer
- Phone
- (573) 815-3072
Corporate family (same tax ID) 4
National Provider Directory
- Tax ID family
- Boone Physician Services LLC
- Part of
- Boone Physician Services LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
1605 E Broadway Ste 200
Columbia, MO 65201-8023
Mailing address
1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-8000
Other providers in Columbia, MO
- Boone County Senior Citizen Service Corporation
- Boone Health Supplies
- Boone Hospital Center'S Visiting Nurses, Inc
- Boone Hospital Center'S Visiting Nurses, Inc.
- Boone Hospital Center'S Visiting Nurses, Inc.
- Boone Physician Services, LLC
- Kendyl Renee Boone
- Cole Borchardt
- Camille Elise Bordelon
- Christal C Borden
All providers in Columbia, MO · Surgery Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.