Kurt Russell Bravata, M.D.

General Practice Physician · Buffalo, MO

Individual Active NPI

NPI number 1790096170

Practice location

201 S Ash St
Buffalo, MO 65622-8674
Phone
(417) 345-6100
Fax
(417) 345-6866

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NPI record

NPI
1790096170
Entity type
Individual (Type 1)
Enumeration date
June 30, 2010
Last updated
December 29, 2016
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Physician Primary 208D00000X 2013030074 MO

Mailing address

1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone
(417) 328-6501
Fax
(417) 328-6338

About Dr. Bravata

Kurt Russell Bravata, M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Physician (code 208D00000X). The practice location is 201 S Ash St, Buffalo, MO 65622-8674. The NPI number 1790096170 was assigned on June 30, 2010 and the record was last updated on December 29, 2016.

Dr. Bravata lists a license in the registry: #2013030074 (MO) for General Practice Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kurt Russell Bravata, M.D.?

The NPI number is 1790096170.

What is the phone number of Dr. Bravata?

The phone number listed for the practice location is (417) 345-6100.

Where is Dr. Bravata located?

201 S Ash St, Buffalo, MO 65622-8674.

What is the taxonomy code for Dr. Bravata?

The primary taxonomy code is 208D00000X – General Practice Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.