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NPI Code Detail

MEDICARE: KEVIN MUNGER D.O.

MEDICARE: KEVIN MUNGER D.O.
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
1207QS0010XSports Medicine (Family Medicine) Physician2018007808MO
2207Q00000XFamily Medicine Physician2018007808MO

General Provider Information

NPI Number : 1982099123
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN MUNGER D.O.
Provider Business Mailing Address
First Line : 600 NE ADAMS DAIRY PKWY
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64014-5493
Country : US
Telephone Number : 816-347-4600
Fax Number : 816-347-4695
Provider Business Practice Location Address
First Line : 600 NE ADAMS DAIRY PKWY
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64014-5493
Country : US
Telephone Number : 816-251-6100
Fax Number : 816-347-4695
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2015
Last Update Date : 08/23/2019

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Directions to “ KEVIN MUNGER D.O.” Practice Location

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