Healthcare Provider Details

I. General information

NPI: 1730683210
Provider Name (Legal Business Name): JOHN AN KUANG CHAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 E RIVER BLUFF BLVD
OZARK MO
65721-8807
US

IV. Provider business mailing address

3756 STATE HWY N
CLEVER MO
65631-6858
US

V. Phone/Fax

Practice location:
  • Phone: 417-885-3000
  • Fax:
Mailing address:
  • Phone: 614-517-8521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number2025029253
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number2025029253
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: