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Individual

BRIAN R EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3536 KUHNE RD, OWENSVILLE, MO 65066
(573) 437-4168
(573) 437-4168
Mailing address
3536 KUHNE RD, CAPITAL REGION MEDICAL CLINIC OWENSVILLE, OWENSVILLE, MO 65066
(573) 437-4168
(573) 437-4242

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2003002799
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
189703
BLUE CROSS BLUE SHIELD
05
208842808
MO
01
2226070
FIRST HEALTH
01
440546366
UNITED HEALTHCARE
01
661032
HEALTHLINK
01
8129934001
CIGNA
01
I13420
MERCY
01
P00189427
RR MEDICARE
Enumeration date
03/09/2006
Last updated
06/15/2012
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