Healthcare Provider Details

I. General information

NPI: 1457594921
Provider Name (Legal Business Name): DUANA CHARIS MESEYTON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 N US HWY 169 SUITE A
TRIMBLE MO
64492
US

IV. Provider business mailing address

PO BOX 4
TRIMBLE MO
64492-0004
US

V. Phone/Fax

Practice location:
  • Phone: 816-298-4332
  • Fax:
Mailing address:
  • Phone: 816-298-4332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2011008008
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: