Provider Demographics
NPI:1861727174
Name:KINSEY, VAN ALAN (DO)
Entity type:Individual
Prefix:DR
First Name:VAN
Middle Name:ALAN
Last Name:KINSEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:893 W HEATHER GLEN RD
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-8218
Mailing Address - Country:US
Mailing Address - Phone:417-849-4199
Mailing Address - Fax:
Practice Address - Street 1:893 W HEATHER GLEN RD
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-8218
Practice Address - Country:US
Practice Address - Phone:417-849-4199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003002970207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice