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Organization
KSB MEDICAL GROUP, INC.
Active
Organization
KSB MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN BRUCE FRAZIER (CFO)
(815) 285-5521
Entity
Organization
Contact information
Practice address
403 E 1ST ST, DIXON, IL 61021-3116
(815) 285-5507
(815) 285-5859
Mailing address
PO BOX 841330, KANSAS CITY, MO 64184-1330
(816) 201-3331
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
01/16/2006
Last updated
12/28/2022
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