Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Executive Pulmonary Medicine, PC

Organization Internal Medicine Physician · NPI 1720041197

Executive Pulmonary Medicine, PC is an Internal Medicine Physician in Poplar Bluff, Missouri. Licensed in Missouri. Registered with an NPI since 2006.

Licensed in
MO
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1906A Greenwood Dr
Poplar Bluff, MO 63901-2430
Phone: (573) 776-7740
Fax: (573) 776-7750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 2003009194 (MO)

Record details

NPI number1720041197
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dennis Daniels — Owner · (573) 776-7740
NPI enumeratedApril 7, 2006
Last updated in NPPESAugust 22, 2020
Mailing addressPo Box 1087, Poplar Bluff, MO 63902-1087

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