Individual
DR. JUSTIN IMHOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 MEDICAL DR, HANNIBAL, MO 63401-6877
(573) 231-3871
(573) 231-3707
Mailing address
100 MEDICAL DR, PO BOX 311, HANNIBAL, MO 63401-6877
(573) 231-3871
(573) 231-3707
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
2011001466
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225066509
—
MO
Enumeration date
06/28/2006
Last updated
06/04/2024
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