Offutt, Cory L.S.

Offutt, Cory L.S. is an individual health care provider with primary practice located at 600 Blues Lake Pkwy , Rolla MO 65401. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Offutt, Cory L.S. can be contacted via phone (573) 364-8822.

Contact Information

Primary practice address
600 Blues Lake Pkwy Rolla MO 65401
Phone: (573) 364-8822
Fax: (573) 202-2403
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2015002436 Missouri

Profile Details

NPI number 1811330806
LBN Legal business name Offutt, Cory L.S.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2013
Last updated Aug 22nd, 2019 - about 7 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 1811330806 NPPES
Missouri MEDICAID 1811330806
Missouri Other 26D0889777

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