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Organization

RANDALL KUNZE DPM LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RANDALL KUNZE DPM (OWNER MANAGER PHYSICIAN)
(417) 358-8566
Entity
Organization

Contact information

Practice address
1503 HAZEL ST, CARTHAGE, MO 64836-2829
(417) 358-8566
(417) 358-2428
Mailing address
PO BOX 424, CARTHAGE, MO 64836-0424
(417) 358-8566
(417) 358-2428

Taxonomy

Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
000634
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
302951702
MO
01
480033764
MEDICARE RAILROAD
MO
05
506137108
MO
05
626137103
MO
01
9912
BCBS MO STANDARD
MO
01
HEALTHLINK
139369
MO
Enumeration date
10/23/2006
Last updated
10/01/2008
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