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Individual

DR. KEESAG A. BARON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1242 E. INDEPENDENCE, SPRINGFIELD, MO 65804-4284
(417) 883-5500
(417) 883-5577
Mailing address
1242 E. INDEPENDENCE, STE. 200, SPRINGFIELD, MO 65804-4284
(417) 883-5500
(417) 883-5577

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
107583
MO
207RC0001X
Clinical Cardiac Electrophysiology Physician
107583
MO
207RI0011X
Interventional Cardiology Physician
107583
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
208048512
MO
01
25634
BC
MO
01
25634
BLUE CROSS/BLUE SHIELD
05
507022101
MO
01
909395531
MEDICARE ID
MO
Enumeration date
06/09/2006
Last updated
08/12/2013
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