Organization
NORTHEAST MISSOURI MEDICAL PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
2305 GEORGIA ST, LOUISIANA, MO 63353-2559
(469) 401-2386
Mailing address
13737 NOEL RD STE 1600, DALLAS, TX 75240-1374
(954) 838-2371
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
06/28/2016
Last updated
06/15/2021
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