Kevin B Imhof, D.O.

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

R2F68 Issued in MO

Practice address

6500 Hospital Dr
Hannibal, MO 63401-6890

Phone

(573) 629-3301

Fax

(573) 629-3336

NPI assigned

Jan 11, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1285613885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "address_2": "P.O. BOX 1239",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-629-3301",
            "fax_number": "573-629-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-629-3301",
            "fax_number": "573-629-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMHOF",
        "first_name": "KEVIN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MO",
            "license": "R2F68",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242661700",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynne Humphreys, DPT
• Haley Hurst, PHARMD
• Iec Surgical Centers LLC
• Brooklynn Imhof, FNP
• Justin Imhof, D.O.
• Emma Inglis
• Amanda M Ingram, RN
• Integrated Dermatology of Northeast Missouri LLC
• International Eyecare Center, Inc
• International Eyecare Center, Inc.

• Otolaryngology/Facial Plastic Surgery Physician in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.