Organization
KENNETT EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES L MURPHY (EXEC. VICE PRESIDENT)
(800) 732-1066
Entity
Organization
Contact information
Practice address
1301 1ST ST, KENNETT, MO 63857-2525
(573) 888-4522
Mailing address
PO BOX 37637, PHILADELPHIA, PA 19101-7637
(800) 732-1066
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220031
BLUE SHIELD
MO
Enumeration date
05/04/2007
Last updated
04/20/2008
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