Healthcare Provider Details

I. General information

NPI: 1861060527
Provider Name (Legal Business Name): PAUL KURTIS ORMSTON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N 25TH ST
OZARK MO
65721-9069
US

IV. Provider business mailing address

505 N 25TH ST
OZARK MO
65721-9069
US

V. Phone/Fax

Practice location:
  • Phone: 417-581-3548
  • Fax:
Mailing address:
  • Phone: 417-581-3548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2024032821
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: