Provider Demographics
NPI:1841710308
Name:ALLERGY & ASTHMA OF SPRINGFIELD, LLC
Entity type:Organization
Organization Name:ALLERGY & ASTHMA OF SPRINGFIELD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SILVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUEBNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:417-885-0823
Mailing Address - Street 1:3231 S NATIONAL AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-7304
Mailing Address - Country:US
Mailing Address - Phone:417-885-0823
Mailing Address - Fax:417-890-4178
Practice Address - Street 1:3231 S NATIONAL AVE STE 200
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7304
Practice Address - Country:US
Practice Address - Phone:417-885-0823
Practice Address - Fax:417-890-4178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1295711620Medicaid
MO1558409748Medicaid