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Individual

DR. PHILIP L RUMBAOA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
Mailing address
1330 GRACE LN, BOONVILLE, MO 65233-2146
(660) 537-0285

Taxonomy

Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
036115065
IL
202K00000X
Phlebology Physician
0426821
KS
202K00000X
Phlebology Physician
Primary
2000163033
MO
207Q00000X
Family Medicine Physician
036115065
IL
207Q00000X
Family Medicine Physician
0426821
KS
207Q00000X
Family Medicine Physician
2000163033
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
25213101
BLUE CROSS BLUE SHIELD OF KANSAS CITY
MO
01
25213121
BLUE CROSS BLUE SHIELD OF KANSAS CITY
KS
Enumeration date
02/07/2006
Last updated
03/17/2018
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