Organization
KENNETH N. AZAN, M.D., PC
Active
Organization
KENNETH N. AZAN, M.D., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH NAJEEB AZAN M.D. (PRESIDENT)
(660) 827-2535
Entity
Organization
Contact information
Practice address
1718 S INGRAM AVE, SUITE C, SEDALIA, MO 65301-7505
(660) 827-2535
(660) 826-5228
Mailing address
1718 S INGRAM AVE, SUITE C, SEDALIA, MO 65301-7505
(660) 827-2535
(660) 826-5228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R6443
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06594013
BLUE CROSS BLUE SHIELD KC
MO
Enumeration date
04/04/2007
Last updated
08/22/2020
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