NPIMap

Organization Active NPI

Eugene C Hansbrough, MD LLC

  • Orthopaedic Surgery Physician
  • Poplar Bluff, MO
National Provider Identifier
1891758223
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
36376 Issued in MO
Legal business name
EUGENE C HANSBROUGH, MD LLC
Practice address
686 Lester St
Poplar Bluff, MO 63901-5025
Phone
(573) 785-9955
NPI assigned
Apr 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Authorized official

Name
Dr. Eugene Hansbrough, MDNPI 1861464828
Title
Owner
Phone
(573) 785-9955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 36376 MO Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

686 Lester St
Poplar Bluff, MO 63901-5025

Mailing address

PO Box 550
Poplar Bluff, MO 63902-0550
Phone (573) 785-4601

Other identifiers 2

IdentifierTypeStateIssuer
5573580001OtherMODME NUMBER
507507606MedicaidMO

National Provider Directory

National Provider Directory

Locations

621 W Pine St
Poplar Bluff, MO 63901
Phone (573) 686-4111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1891758223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639020550",
            "telephone_number": "573-785-4601",
            "fax_number": "573-686-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "686 LESTER ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015025",
            "telephone_number": "573-785-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE C HANSBROUGH, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "HANSBROUGH",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-785-9955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "36376",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME NUMBER",
            "identifier": "5573580001",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507507606",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.