Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Plastic and Reconstructive Surgery of Mid-Missouri, Inc

Organization Plastic Surgery Physician · NPI 1063739159

Plastic and Reconstructive Surgery of Mid-Missouri, Inc provides Plastic Surgery Physician services in Columbia, Missouri. Licensed in Missouri. Registered with an NPI since 2010.

Licensed in
MO
In the registry since
2010
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1701 E Broadway Ste 304
Columbia, MO 65201-8018 Not confirmed with CMS for 16 years — call before visiting
Phone: (573) 876-1700
Fax: (573) 876-1705
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence R5577 (MO)

Record details

NPI number1063739159
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Royer — Administrator · (573) 777-1191
NPI enumeratedApril 28, 2010
Last updated in NPPESApril 28, 2010
Mailing address1701 E Broadway, Suite 304, Columbia, MO 65201-8018

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