Provider Demographics
NPI:1194160028
Name:ROMNEY, JARED KARL (DO)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:KARL
Last Name:ROMNEY
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 1:4740 NW RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:MO
Mailing Address - Zip Code:64150-1102
Mailing Address - Country:US
Mailing Address - Phone:760-505-8566
Mailing Address - Fax:
Practice Address - Street 1:2305 S HIGHWAY 65
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340-3702
Practice Address - Country:US
Practice Address - Phone:660-886-7431
Practice Address - Fax:660-831-3325
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016011320207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty