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Individual

DONALD K MCNUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2713 INDUSTRIAL DR, SUITE C, JEFFERSON CITY, MO 65109-6705
(573) 634-7884
(573) 634-3146
Mailing address
2713 INDUSTRIAL DRIVE, SUITE C, JEFFERSON CITY, MO 65109-5195
(573) 634-7884
(573) 634-3146

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R7J08
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
242921435
MO
Enumeration date
09/21/2006
Last updated
11/15/2013
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