Healthcare Provider Details

I. General information

NPI: 1083841753
Provider Name (Legal Business Name): KARLI ROSS ECHTERLING URBAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARLI ROSS ECHTERLING

II. Dates (important events)

Enumeration Date: 06/19/2009
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 E SOUTHAMPTON DR
COLUMBIA MO
65201-4236
US

IV. Provider business mailing address

PO BOX 843966
KANSAS CITY MO
64184-3966
US

V. Phone/Fax

Practice location:
  • Phone: 573-884-7733
  • Fax: 573-882-6228
Mailing address:
  • Phone: 573-884-3300
  • Fax: 573-884-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number2012041513
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2012041513
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: