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NPI Code Detail

MEDICARE: GEORGE M AUSTIN M.D

MEDICARE:   GEORGE M AUSTIN  M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistR8754MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2340004705OTHERMORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
107414054OTHERMOBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1336143296
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE M AUSTIN M.D
Provider Business Mailing Address
First Line : 206 NW MOCK AVE
Second Line : STE 200
City : BLUE SPRINGS
State : MO
Zip : 64014-2530
Country : US
Telephone Number : 816-224-8999
Fax Number : 816-224-3121
Provider Business Practice Location Address
First Line : 206 NW MOCK AVE
Second Line : STE 200
City : BLUE SPRINGS
State : MO
Zip : 64014-2530
Country : US
Telephone Number : 816-224-8999
Fax Number : 816-224-3121
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 07/14/2010

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Directions to “ GEORGE M AUSTIN M.D” Practice Location

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