person
Dr. Kurt Russell Bravata, MD
General Practice Physician in Buffalo, Missouri
NPI 1790096170

Kurt Russell Bravata is a General Practice Physician based in Bolivar, MO. Kurt Russell Bravata practices in Buffalo, MO and has the professional credentials of MD. The NPI Number for Kurt Russell Bravata is 1790096170 and holds a License No. 2013030074 (Missouri).

The current practice location address for Kurt Russell Bravata is 201 S Ash St, Buffalo, MO and can be reached out via phone at 417-345-6100 and via fax at 417-345-6866. You can also correspond with Kurt Russell Bravata through the mailing address at 1500 N OAKLAND AVE, BOLIVAR, MO - 65613-3011 (mailing address contact number: 417-328-6501).

Location: 201 S Ash St, Buffalo, MO, 65613-3011
person
Provider Profile Details
NPI Number
1790096170
Provider Name
Kurt Russell Bravata
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
201 S Ash St, Buffalo, MO, 65613-3011
Phone Number
417-345-6100
Fax Number
417-345-6866
Provider Enumeration Date
06/30/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P01259379 01 MO PALMETTO GBA RAILROAD
institution
Provider Business Practice Location Address Details
Address
201 S Ash St
City
State
Zip
65622-8674
Phone Number
417-345-6100
Fax Number
417-345-6866
person
Provider Business Mailing Address Details
Address
1500 N Oakland Ave
City
State
Zip
65613-3011
Phone Number
417-328-6501
Fax Number
417-328-6338
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
2013030074 (Missouri)
Definition
Definition to come...
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