Duncan O Abongo, OT
Individual provider Active NPI Specialist · Brookfield, MO
NPI 1740413822 · NPPES record last updated Aug 24, 2009
Key facts
- NPI
- 1740413822
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 003391 (MO)
- Practice address
- 209 Percy LN
Brookfield, MO 64628-1951 - Phone
- (166) 073-4063
- NPI assigned
- Aug 24, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003391 | MO | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NHC Healthcare-Macon LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 003391 | MO | Yes |
Addresses
Primary practice location
209 Percy LN
Brookfield, MO 64628-1951
Mailing address
209 Percy LN
Brookfield, MO 64628-1951
Phone (166) 073-4063
Other providers in Brookfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.