Central Missouri Surgery LLC

NPI #1891012878 in Columbia, Missouri

Provider Information

NPI Number: 1891012878
Entity Type: Organization
Organization Name: Central Missouri Surgery LLC
Primary Specialty: Surgery
Enumeration Date: Apr 29, 2010
Last Updated: Jul 29, 2010

Practice Location

Address: 401 KEENE ST
Address 2: THE BOONE CLINIC BUILDING
City: Columbia
State: Missouri
ZIP Code: 65201-6625
Phone: (573) 876-1630

Authorized Official

Name: KIMBERLY C SUPPES, M.D.
Title: SOLE MEMBER
Phone: (573) 876-1630

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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