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KEVIN LUCAS INGALLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-1026
(573) 884-8876
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2008020873
MO
2085R0202X
Diagnostic Radiology Physician
Primary
2012027552
MO

Other

Enumeration date
07/22/2008
Last updated
08/02/2013
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