Individual
DR. ERIC F. KONDRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1225 AGUILAR DRIVE, MONTGOMERY CITY, MO 63361
(573) 582-1234
Mailing address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 582-1234
(573) 582-1212
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
109389
MO
207R00000X
Internal Medicine Physician
109389
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208113605
—
MO
Enumeration date
12/14/2005
Last updated
12/27/2022
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