Individual
GREGORY HAVERMALE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1150 STATE HIGHWAY 248 STE 202, BRANSON, MO 65616-3729
(417) 335-2299
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 730-6430
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2018012786
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200070827
—
MO
Enumeration date
06/22/2015
Last updated
10/27/2025
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