Provider Demographics
NPI:1659565695
Name:G & R HEALTH ASSOCIATES INC
Entity Type:Organization
Organization Name:G & R HEALTH ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MEAD
Authorized Official - Last Name:GAUNT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:660-827-4433
Mailing Address - Street 1:1710 S LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-7542
Mailing Address - Country:US
Mailing Address - Phone:660-827-4433
Mailing Address - Fax:660-827-4466
Practice Address - Street 1:1710 S LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-7542
Practice Address - Country:US
Practice Address - Phone:660-827-4433
Practice Address - Fax:660-827-4466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8919207R00000X
MOR4A061207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1030000OtherMEDICARE LEGACY
MO503823700Medicaid
MO7004608OtherCIGNA
MO210180OtherHEALTHTHLINK
MO08507013OtherBCBS
MOE48327Medicare UPIN
MO503823700Medicaid