Provider Demographics
NPI:1467465237
Name:KAICHER, JOHN H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:KAICHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65742-9357
Mailing Address - Country:US
Mailing Address - Phone:417-753-9404
Mailing Address - Fax:417-753-9137
Practice Address - Street 1:101 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65742-9357
Practice Address - Country:US
Practice Address - Phone:417-753-9404
Practice Address - Fax:417-753-9137
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD119698207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
119346OtherBLUE CROSS
MO204682801Medicaid
F52391Medicare UPIN
011011890Medicare PIN
MO204682801Medicaid
119346OtherBLUE CROSS
110192057Medicare PIN