Organization
EDMUND C LANDRY M D P C
Active
Other names
Kennett Orthoaedic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDMUND C LANDRY MD (PRESIDENT)
(573) 888-2831
Entity
Organization
Contact information
Practice address
402 RECOVERY RD, KENNETT, MO 63857-3235
(573) 888-2831
(573) 888-5408
Mailing address
402 RECOVERY RD, KENNETT, MO 63857-3235
(573) 888-2831
(573) 888-5408
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2000146363
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125262
ANTHEM BC OF MISSOURI
MO
01
—
425643
HEALTHLINK
MO
01
—
98523
AR BLUE CROSS
MO
Enumeration date
11/01/2006
Last updated
04/20/2008
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