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Individual

DOUGLAS W KIBURZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2301 S INGRAM AVE, SEDALIA, MO 65301-8121
(660) 826-5890
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(660) 826-5890

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
R5F84
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
509999207
MO
Enumeration date
03/15/2006
Last updated
03/15/2016
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