Individual
KUSAI A UMRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 N MAIN ST, MOUNT VERNON, MO 65712-1004
(417) 461-5312
(417) 461-5765
Mailing address
600 N MAIN ST, MOUNT VERNON, MO 65712-1004
(417) 461-5312
(417) 461-5765
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2001003866
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205281801
—
MO
Enumeration date
12/15/2005
Last updated
12/22/2011
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