Healthcare Provider Details

I. General information

NPI: 1104288646
Provider Name (Legal Business Name): KURT SCHROER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2305 S HIGHWAY 65 BLDG A
MARSHALL MO
65340-3702
US

IV. Provider business mailing address

2305 S HIGHWAY 65 BLDG A
MARSHALL MO
65340-3702
US

V. Phone/Fax

Practice location:
  • Phone: 660-886-7800
  • Fax: 660-831-3328
Mailing address:
  • Phone: 660-886-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2021048841
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: