OrganizationActive
Retired
NPI 1962818435 · Medical Specialty Clinic/Center · Hallsville, MO
Provider details
- NPI number
- 1962818435
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Herb Bastow, Urologist(573) 696-2391
- License
- R5108 (MO)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
13714 N Sportsmans Dr
Hallsville, MO 65255-9330
Phone: (573) 696-2391
Approximate (ZIP-level) locationGet directions
Mailing address
13714 N Sportsmans Dr
Hallsville, MO 65255-9330
Registry dates
- Enumerated
- 2014-07-06
- Last updated
- 2014-07-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.