Healthcare Provider Details

I. General information

NPI: 1861409625
Provider Name (Legal Business Name): DONET CHRISTOPHER MAIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 PROSPECT DR
MACON MO
63552-2615
US

IV. Provider business mailing address

PO BOX 402
MACON MO
63552-0402
US

V. Phone/Fax

Practice location:
  • Phone: 660-385-1006
  • Fax: 660-385-1028
Mailing address:
  • Phone: 660-385-1008
  • Fax: 660-385-1062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number110583
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: