Individual
DR. KEITH KENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 VIRGINIA AVE, COLUMBIA, MO 65212-0001
(573) 882-2663
(573) 882-1760
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2024034861
MO
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
2024034861
MO
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
4301108728
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200044257
RAILROAD MEDICARE
OH
01
—
200044258
RAILROAD MEDICARE
KY
05
—
200380900
—
IN
05
—
2322758
—
OH
05
—
64051741
—
KY
Enumeration date
05/03/2006
Last updated
08/27/2024
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