Basic Information
| Provider Information | |||||||||
| NPI: | 1760796775 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NTUI-AYUK | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | NTUI | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 525 BRANSON LANDING BLVD. | ||||||||
| Address2: | |||||||||
| City: | BRANSON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 65616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4173357128 | ||||||||
| FaxNumber: | 4173357588 | ||||||||
| Practice Location | |||||||||
| Address1: | 251 SKAGGS RD | ||||||||
| Address2: | |||||||||
| City: | BRANSON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 656162031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4173357128 | ||||||||
| FaxNumber: | 4173357588 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2010 | ||||||||
| LastUpdateDate: | 04/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | MD25572 | ME | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 2012020695 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1760796775 | 05 | MO | MEDICAID |