Organization
KIRKSVILLE ANESTHESIA ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELVIN C. ROOF D.O. (PRESIDENT)
(660) 785-1000
Entity
Organization
Contact information
Practice address
800 W JEFFERSON ST, NORTHEAST REGIONAL MEDICAL CENTER, KIRKSVILLE, MO 63501-1443
(660) 785-1000
(660) 785-1237
Mailing address
PO BOX 702, KIRKSVILLE, MO 63501-0702
(660) 785-1000
(660) 785-1237
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0976845
—
IA
01
—
1205
BLUE CROSS, BLUE SHIELD
—
01
—
299013
BLACK LUNG
—
05
—
503208209
—
MO
01
—
8298
HEALTHCARE USA
MO
01
—
CG4336
RAILROAD MEDICARE
—
Enumeration date
07/15/2006
Last updated
08/21/2008
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