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General NPI Number Information
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NPI Number | 1699717678
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Entity Type | Individual
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Provider Name | MICHAEL A KUTMAS D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 100 MERCY WAY
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City | JOPLIN
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State | MO
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Zip | 64804-4524
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Country | US
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Telephone | 417-556-2300
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Fax | 417-556-3625
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Provider Business Mailing Address
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Address Line | 3125 DR RUSSELL SMITH WAY
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City | CARTHAGE
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State | MO
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Zip | 64836-7402
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Country | US
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Telephone | 417-455-0395
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Fax | 417-455-0395
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | R8E70
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R8E70
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License Number State | MO
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