Individual
DR. KEVIN B IMHOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6500 HOSPITAL DR, HANNIBAL, MO 63401-6890
(573) 629-3301
(573) 629-3336
Mailing address
6500 HOSPITAL DR, P.O. BOX 1239, HANNIBAL, MO 63401-6890
(573) 629-3301
(573) 629-3336
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
R2F68
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242661700
—
MO
Enumeration date
01/11/2006
Last updated
01/06/2016
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