Dominguez, Jose M

Dominguez, Jose M is an individual health care provider with primary practice located at 1001 E Primrose St , Springfield MO 65807-5155. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is his primary health care specialty. Dominguez, Jose M can be contacted via phone (417) 875-3276.

Contact Information

Primary practice address
1001 E Primrose St Springfield MO 65807-5155
Phone: (417) 875-3276
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 107891 Missouri
Allopathic & Osteopathic Physicians / Surgery 208600000X 107891 Missouri

Profile Details

NPI number 1295773927
LBN Legal business name Dominguez, Jose M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295773927 NPPES
Other 106986 BLUE CROSS/BLUE SHIELD
MEDICAID 207976002 BLUE CROSS/BLUE SHIELD

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