IndividualActive
Cysco Merisotes
NPI 1073319232 · Surgical Physician Assistant · Springfield, MO
Provider details
- NPI number
- 1073319232
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 2025000589 (MO)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2115 S Fremont Ave Ste 5000
Springfield, MO 65804-2230
Phone: (417) 820-3912
Approximate (ZIP-level) locationGet directions
Mailing address
46 W Cherry St
Fair Grove, MO 65648-8433
Registry dates
- Enumerated
- 2025-02-19
- Last updated
- 2025-02-19
- Certified
- 2025-02-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.