Provider Demographics
NPI:1760590376
Name:UROLOGY CONSULTANTS OF CENTRAL MISSOURI
Entity Type:Organization
Organization Name:UROLOGY CONSULTANTS OF CENTRAL MISSOURI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DRESNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-499-4990
Mailing Address - Street 1:1705 E BROADWAY
Mailing Address - Street 2:SUITE 340
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-7166
Mailing Address - Country:US
Mailing Address - Phone:573-499-4990
Mailing Address - Fax:573-443-6294
Practice Address - Street 1:1705 E BROADWAY
Practice Address - Street 2:SUITE 340
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-7166
Practice Address - Country:US
Practice Address - Phone:573-499-4990
Practice Address - Fax:573-443-6294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1528047974OtherRAILROAD MEDICARE PIN
KSK70A884Medicare PIN
MO000080398Medicare ID - Type Unspecified
1528047974OtherRAILROAD MEDICARE PIN
MOS76676Medicare UPIN
MOC51742Medicare UPIN
KSK70A883Medicare PIN
MOE59490Medicare UPIN
MO000003385Medicare ID - Type Unspecified
KSK700000Medicare PIN
KSK706873Medicare PIN