Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 101657 | MO |
NPI | 1275534786 |
---|---|
Provider Name | Dr. Billy W Strait |
First Address | Kirksville, MO 63501-1443 |
Second Address | Kirksville, MO 63501-1443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 16/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
246991202 | (05) | MS |
F57750 | (02) |