Organization
PERRY KIDS PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHARGAV M KANANI M.D. (ADMINISTRATOR)
(573) 517-0999
Entity
Organization
Contact information
Practice address
210 HOSPITAL LN, PERRYVILLE, MO 63775-1276
(573) 517-0999
(573) 517-0812
Mailing address
210 HOSPITAL LANE, PERRYVILLE, MO 63670
(573) 517-0999
(543) 517-0812
Taxonomy
Speciality
Code
Description
License number
State
2080T0002X
Pediatric Medical Toxicology Physician
Primary
MO105937
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
599297306
—
MO
Enumeration date
05/07/2008
Last updated
05/07/2008
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