Provider Demographics
NPI:1891826269
Name:RASMUSSEN, CHARLES SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:SCOTT
Last Name:RASMUSSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:525 BRANSON LANDING BLVD
Mailing Address - Street 2:STE. 508
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2052
Mailing Address - Country:US
Mailing Address - Phone:417-335-7540
Mailing Address - Fax:417-335-7588
Practice Address - Street 1:310 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5572
Practice Address - Country:US
Practice Address - Phone:620-275-9752
Practice Address - Fax:620-275-4306
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0061567207Q00000X
MO2005019384207Q00000X
KS05-45220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1891826269Medicaid
MO263496OtherMEDICARE RHC
MO1891826269Medicaid