Individual
DR. DALE EDWARD KORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3916 S PROVIDENCE RD STE 101, COLUMBIA, MO 65203-7152
(573) 882-1662
(573) 882-4096
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
110734
MO
207Q00000X
Family Medicine Physician
110734
MO
208000000X
Pediatrics Physician
110734
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204700009
—
MO
01
—
98648
BLUE CROSS ARKANSAS
AK
Enumeration date
08/22/2006
Last updated
11/10/2022
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