Healthcare Provider Details

I. General information

NPI: 1427748516
Provider Name (Legal Business Name): RACHEL ANNE OURSBOURN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL ANNE WRIGHT

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N KEENE ST STE 404
COLUMBIA MO
65201-8054
US

IV. Provider business mailing address

303 N KEENE ST STE 404
COLUMBIA MO
65201-8054
US

V. Phone/Fax

Practice location:
  • Phone: 573-777-7627
  • Fax: 573-777-4596
Mailing address:
  • Phone: 573-777-7627
  • Fax: 573-777-4596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number41337
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: