Individual
DR. KENNETH NAJEEB AZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1718 S INGRAM AVE, SUITE C, SEDALIA, MO 65301-7505
(660) 827-2535
(660) 826-5228
Mailing address
1718 S INGRAM AVE, SUITE C, SEDALIA, MO 65301-7505
(660) 827-2535
(660) 826-5228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R6443
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06594013
BLUE CROSS BLUE SHIELD KC
MO
01
—
111077637
RAILROAD MEDICARE
MO
05
—
200112605
—
MO
Enumeration date
06/27/2006
Last updated
01/21/2014
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