Individual
DR. JUSTIN M. POORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1100 HIGHLAND DR, FL 3, CONCORDIA, KS 66901-3923
(785) 243-4272
(785) 243-4275
Mailing address
1518 QUAIL RD, CONCORDIA, KS 66901-6885
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0529357
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100415450B
—
KS
Enumeration date
05/24/2005
Last updated
12/29/2009
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