Individual
DR. RICHARD S MAKUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
525 BRANSON LANDING BLVD, BRANSON, MO 65616-2052
(417) 335-7000
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2003011834
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100457390A
—
KS
05
—
208799007
—
MO
Enumeration date
07/13/2005
Last updated
08/26/2021
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