Provider Demographics
NPI:1922018613
Name:KUNIN, JEFFREY R (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:R
Last Name:KUNIN
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:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-1026
Practice Address - Fax:573-884-4487
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1033852085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO300089027OtherRAILROAD MEDICARE
MO206667008Medicaid
MOP00475719OtherRAILROAD MEDICARE
MO19542081OtherBCBS KC GRP#18959016
KS100144440BMedicaid
MO19542071OtherBCBS OF KCMO
MO300085114OtherRAILROAD MEDICARE
MO206667008Medicaid
KS100144440BMedicaid
MO19542081OtherBCBS KC GRP#18959016
MOD08000004Medicare PIN
MOW19000116Medicare PIN