Individual
ANTHONY PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
315 S OSTEOPATHY AVE, KIRKSVILLE, MO 63501-6401
(660) 785-1000
(660) 785-1154
Mailing address
315 S OSTEOPATHY AVE, KIRKSVILLE, MO 63501-6401
(660) 785-1000
(660) 785-1154
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2024040709
MO
207Q00000X
Family Medicine Physician
2023022824
MO
207Q00000X
Family Medicine Physician
Primary
2024040709
MO
Other
Enumeration date
06/15/2023
Last updated
07/25/2025
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