| Doctor Name: | MR. CHARLES CHRISTOPHER GOSSMAN |
| NPI Number: | 1164703153 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APRN |
| License Number: | 52-75482-121 |
| Business Practice Address: | 6055 N Main Street Rd Webb City, MO - 648707219 |
| Business Phone Number: | 4172060900 |
| Business Fax Number: | 4172060907 |
| Mailing Address: | 6055 N Main Street Rd, WEBB CITY |
| State: | MO |
| Postal Code: | 648707219 |
| Phone Number: | 4172060900 |
| Fax Number: | 4172060907 |
| NPI Enumeration Date: | 09/02/2011 |
| NPI Last Update Date: | 10/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 52-75482-121 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |