# GLENN A KUNKEL MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649255894
- **Authorized official:** DR. GLENN A KUNKEL MD (OWNER)
- **Authorized official phone:** (660) 826-5960

## Contact information

- **Practice address:** 1000 W 10TH ST, ROLLA, MO 65401-2905
- **Practice address phone:** (660) 826-5960
- **Practice address fax:** (660) 826-4852
- **Mailing address:** PO BOX 1547, SEDALIA, MO 65302-1547
- **Mailing address phone:** (660) 826-5960
- **Mailing address fax:** (660) 826-4852

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 113756 | MO | Yes |

## Other

- **Enumeration date:** 12/09/2005
- **Last updated:** 08/22/2020