Individual
DR. KEVIN M RENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
225 PHYSICIANS PARK STE 102, POPLAR BLUFF, MO 63901-3918
(573) 785-4546
(573) 785-6959
Mailing address
225 PHYSICIANS PARK DRIVE, SUITE 102, POPLAR BLUFF, MO 63901
(573) 785-4546
(573) 785-6959
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2017016516
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017016516
MO LICENSE
MO
Enumeration date
03/28/2014
Last updated
07/21/2022
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