Provider Demographics
NPI:1548320351
Name:KOSSE, KARL E (MD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:E
Last Name:KOSSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3902 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3648
Mailing Address - Country:US
Mailing Address - Phone:816-279-7337
Mailing Address - Fax:816-279-7340
Practice Address - Street 1:3902 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3648
Practice Address - Country:US
Practice Address - Phone:816-279-7337
Practice Address - Fax:816-279-7340
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO102761174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist