Individual
KELLY DOUGLAS BURCHETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1605 SOUTH BALTOMORE, SUITE B, KIRKSVILLE, MO 63501
(660) 665-3599
(660) 665-3570
Mailing address
1605 SOUTH BALTIMORE, SUITE B, KIRKSVILLE, MO 63501
(660) 665-3599
(660) 665-3570
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
2001010344
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207392200
—
MO
Enumeration date
10/02/2006
Last updated
09/09/2020
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