Provider Demographics
NPI:1750523510
Name:KENNETT HMA PHYSICIANS MANAGEMENT, INC.
Entity type:Organization
Organization Name:KENNETT HMA PHYSICIANS MANAGEMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BLURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-888-8477
Mailing Address - Street 1:PO BOX 747
Mailing Address - Street 2:402 RECOVERY ROAD
Mailing Address - City:KENNETT
Mailing Address - State:MO
Mailing Address - Zip Code:63857-0747
Mailing Address - Country:US
Mailing Address - Phone:573-888-0274
Mailing Address - Fax:573-888-1225
Practice Address - Street 1:402 RECOVERY RD
Practice Address - Street 2:
Practice Address - City:KENNETT
Practice Address - State:MO
Practice Address - Zip Code:63857-3235
Practice Address - Country:US
Practice Address - Phone:573-888-0274
Practice Address - Fax:573-888-1225
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENNETT HMA PHYSICIANS MANAGEMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SX0106XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOccupational HealthGroup - Single Specialty