Basic Information
| Provider Information | |||||||||
| NPI: | 1326275868 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DARROUJ | ||||||||
| FirstName: | JAMIL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2580 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658012580 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178294620 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3231 S NATIONAL AVE | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658077304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178885696 | ||||||||
| FaxNumber: | 4178886711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2009 | ||||||||
| LastUpdateDate: | 11/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2008028523 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | 2008028523 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | P00735775 | 01 | RAILROAD MEDICARE | OTHER | 1326275868 | 05 | MO | MEDICAID | 178242001 | 05 | AR | MEDICAID | 431560263 | 01 | TRICARE WEST | OTHER |