Individual
SUSAN K AILOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
115 BUSINESS LOOP 70 W, COLUMBIA, MO 65201
(573) 882-8445
(573) 884-4134
Mailing address
PO BOX 7687, COLUMBIA, MO 65202
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
R2K92
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137120
HEALTHLINK
MO
01
—
185188
BLUE SHIELD
MO
05
—
202764916
—
MO
Enumeration date
10/06/2006
Last updated
04/25/2012
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