Individual
PAUL MARC JOUBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8550 MARSHALL DR, SUITE 220 ADMINISTRATION, LENEXA, KS 66214-1505
(913) 495-2000
(913) 495-3727
Mailing address
615 SW 3RD ST, LEES SUMMIT, MO 64063-2212
(816) 524-3799
(913) 495-3727
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R4J19
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243156007
—
MO
01
—
P01023740
RR MEDICARE
MO
Enumeration date
08/22/2005
Last updated
12/18/2012
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