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NPI Code Detail

MEDICARE: DR. GARY C. KITTO AND ASSOCIATES

MEDICARE: DR. GARY C. KITTO AND ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
122580011OTHERMOBLUE CROSS / BLUE SHIELD

General Provider Information

NPI Number : 1467454645
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. GARY C. KITTO AND ASSOCIATES
Provider Business Mailing Address
First Line : 100 S LIMIT AVE
Second Line :
City : SEDALIA
State : MO
Zip : 65301-3655
Country : US
Telephone Number : 660-826-7909
Fax Number : 660-826-6737
Provider Business Practice Location Address
First Line : 100 S LIMIT AVE
Second Line :
City : SEDALIA
State : MO
Zip : 65301-3655
Country : US
Telephone Number : 660-826-7909
Fax Number : 660-826-6737
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : MR. GARY C KITTO
Credential : PH D M.S
Telephone Number : 660-826-7909
Provider Enumeration Date : 06/01/2005
Last Update Date : 08/22/2020

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