Individual
JEREMY MATTHEW GEBHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-6500
(573) 884-0437
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2021036929
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015035959
STATE LICENSE
MO
Enumeration date
09/29/2015
Last updated
08/23/2022
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