Neosho Bone & Joint Clinic P.C.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

R9N57 Issued in MO

Legal business name

NEOSHO BONE & JOINT CLINIC P.C.

Practice address

4040 Laquesta Drive
Neosho, MO 64850-2849

Phone

(417) 451-1833

Fax

(417) 451-1825

NPI assigned

Nov 20, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Alen Petersen

Title

Manager

Phone

(417) 451-1833

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Horace Rex Petersen, D.O.

  • Orthopaedic Surgery Physician
  • Neosho, MO
  • NPI 1568460590
  NPD (past)

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258675200000",
    "number": "1942538541",
    "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": "648502849",
            "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": "648502849",
            "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": "2009-11-20",
        "last_updated": "2009-11-20",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ALEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "417-451-1833",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "R9N57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246862114",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 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
• Neosho Residential, LLC

• Orthopaedic Surgery Physician in Neosho, MO
• Providers in Neosho, MO by specialty
• Orthopaedic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.