Central Missouri Urology Clinic, Inc

LBN: Central Missouri Urology Clinic, Inc
Central Missouri Urology Clinic, Inc is an health care organization with primary practice located at 1428 East 72 Highway , Rolla MO 65401. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Central Missouri Urology Clinic, Inc can be contacted via phone (573) 364-1014, or through Kaczmarek, Anthony Thomas via phone (573) 364-1014.

Contact Information

Primary practice address
1428 East 72 Highway Rolla MO 65401
Phone: (573) 364-1014
Fax: (573) 364-6872
Website:
Map and Directions
Authorized official contact:
Name: Kaczmarek, Anthony Thomas Doctor of Medicine (MD)
Phone: (573) 364-1014

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 110031 Missouri

Profile Details

NPI number 1710940630
LBN Legal business name Central Missouri Urology Clinic, Inc
DBA Doing business as
Authorized official Kaczmarek, Anthony Thomas Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 11th, 2006
Last updated Jun 29th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710940630 NPPES
Missouri MEDICAID 208305102

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