NPI 1740858562 · live from the CMS NPI Registry
Big Tree Medical Group LLC
Family Medicine in Columbia, MO. National Provider Identifier 1740858562, active.
NPI record
| NPI | 1740858562 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 200 Corporate Lake Dr, Columbia, MO 65203 |
| Practice phone | 573-814-1170 |
| Enumerated | June 17, 2021 |
| Last updated | January 4, 2023 |
| Authorized official | Adam Wheeler, Ceo |
| Other names | Big Tree Medical Home |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | — |
| Allergy & Immunology | 207K00000X | — |
| Community/Behavioral Health | 251S00000X | — |
| Family Medicine primary | 207Q00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.