Organization
RANDALL KUNZE DPM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL KUNZE DPM (OWNER)
(417) 358-8566
Entity
Organization
Contact information
Practice address
1503 HAZEL ST, CARTHAGE, MO 64836-2829
(417) 358-8566
(417) 358-2428
Mailing address
PO BOX 424, CARTHAGE, MO 64836-0424
(417) 358-8566
(417) 358-2428
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
000634
MO
332BC3200X
Customized Equipment (DME)
000634
MO
335E00000X
Prosthetic/Orthotic Supplier
000634
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139389
HEALTHLINK
MO
05
—
302951702
—
MO
05
—
506137108
—
MO
01
—
9912
BCBS MO
MO
01
—
DF2473
MC RAILROAD GROUP
—
01
—
P00350052
MC RAILROAD
NE
Enumeration date
08/29/2007
Last updated
09/30/2008
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