Provider Demographics
NPI:1154571974
Name:CHRIS WEBER MD LLC
Entity type:Organization
Organization Name:CHRIS WEBER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-337-5500
Mailing Address - Street 1:574 STATE HIGHWAY 248
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-7740
Mailing Address - Country:US
Mailing Address - Phone:417-337-5500
Mailing Address - Fax:417-337-5568
Practice Address - Street 1:574 STATE HIGHWAY 248
Practice Address - Street 2:SUITE 3
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-7740
Practice Address - Country:US
Practice Address - Phone:417-337-5500
Practice Address - Fax:417-337-5568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO118855261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOG23751Medicare UPIN