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Specialty details in registry · Kirksville, MO

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At a glance

1503 E Northtown Rd, Kirksville, MO 63501-2080

NPPES record updated Jun 14, 2008. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

1503 E Northtown Rd
Kirksville, MO 63501-2080
Professional details: NPI, taxonomy & registry record
NPI1790814176
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
320600000X
Enumeration date
Mar 3, 2007
Record updated
Jun 14, 2008
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

320600000X · Primary

License reported: 5622-8623 MO

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1503 E Northtown Rd
Kirksville, MO 63501-2080
Phone
(660) 665-9336
Fax
(660) 665-9336
Mailing address
1503 E NORTHTOWN RD

KIRKSVILLE, MO 635012080
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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