Healthcare Provider Details

I. General information

NPI: 1689950883
Provider Name (Legal Business Name): AARON L RUPP D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 05/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 BURKARTH RD STE 201
WARRENSBURG MO
64093
US

IV. Provider business mailing address

403 BURKARTH RD
WARRENSBURG MO
64093-3101
US

V. Phone/Fax

Practice location:
  • Phone: 660-747-2228
  • Fax: 660-747-7677
Mailing address:
  • Phone: 660-747-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2011034010
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: