Individual
DR. KEVIN GERARD BYRNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1029 NICHOLS RD STE 201, OSAGE BEACH, MO 65065-3008
(573) 302-7138
(573) 302-7123
Mailing address
1029 NICHOLS RD STE 201, OSAGE BEACH, MO 65065-3008
(573) 302-7138
(573) 302-7123
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
DO107693
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110198631
RR MEDICARE
MO
05
—
247961113
—
MO
Enumeration date
11/17/2005
Last updated
07/21/2022
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