Healthcare Provider Details

I. General information

NPI: 1750379889
Provider Name (Legal Business Name): JOSE GERARDO FIGUEROA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16528 S WOODSTONE DR
OLATHE KS
66062-9509
US

IV. Provider business mailing address

800 EAST CARPENTER STREET ROOM 2K64
SPRINGFIELD IL
62769-0001
US

V. Phone/Fax

Practice location:
  • Phone: 217-717-7172
  • Fax:
Mailing address:
  • Phone: 217-525-5643
  • Fax: 217-544-3311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036070640
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2017040127
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number2017040127
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: