Neosho Bone & Joint Clinic P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

R9N57 Issued in MO

Legal business name

NEOSHO BONE & JOINT CLINIC P.C.

Practice address

4040 Laquesta Drive
Neosho, MO 64850

Phone

(417) 451-1833

Fax

(417) 451-1825

NPI assigned

Aug 29, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Horace Rex Petersen, D.O.

Title

Orthopedic Surgeon

Phone

(417) 451-1833

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1356599641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 LAQUESTA DR.",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "64850",
            "telephone_number": "417-451-1833",
            "fax_number": "417-451-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 LAQUESTA DRIVE",
            "city": "NEOSHO",
            "state": "MO",
            "postal_code": "64850",
            "telephone_number": "417-451-1833",
            "fax_number": "417-451-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOSHO BONE & JOINT CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-29",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "HORACE",
        "authorized_official_middle_name": "REX",
        "authorized_official_title_or_position": "ORTHOPEDIC SURGEON",
        "authorized_official_telephone_number": "417-451-1833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MO",
            "license": "R9N57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246862114",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Mues, COTA
• Charles A Mulik, RP.H
• Destinee Mullinix, PTA
• Emily Lynn Murphy, ARNP
• Preston L Myers, NP-C
• Neosho Bone & Joint Clinic P.C.
• Neosho Kids Dental, LLC
• Neosho Optical Inc
• Neosho Powersports, Inc.
• Neosho R-V School District

• Specialist in Neosho, MO
• Providers in Neosho, MO by specialty
• Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.