Dr. George T Koburov
Pediatric Emergency Physician
404 N Keene St
Columbia
, Missouri 65201-6626
Dr. George T Koburov
Pediatric Emergency Physician
404 N Keene St
Columbia
, Missouri 65201-6626
(573) 884-0943
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About
Features
Specialties
- Pediatric Emergency Physician
Languages spoken
- English
Location
First Address
- Dr. George T Koburov
- Po Box 843966
- Kansas City, MO
- Zip : 64184-3966
- Fax : (573) 884-0943
- Phone : (573) 884-3300
Second Address
- Dr. George T Koburov
- 404 N Keene St
- Columbia, MO
- Zip : 65201-6626
- Fax : (573) 874-1547
- Phone : (573) 875-9400
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PP0204X | Pediatric Emergency Physician | 2012015982 | MO |
National Provider Identifier
| NPI | 1205995008 |
|---|---|
| Provider Name | Dr. George T Koburov |
| First Address | Kansas City, MO 64184-3966 |
| Second Address | Columbia, MO 65201-6626 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/12/2006 |
| Last Update Date | 12/08/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 205647605 | (05) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.