Healthcare Provider Details

I. General information

NPI: 1508059239
Provider Name (Legal Business Name): MELVIN L MCFARLIN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2007
Last Update Date: 04/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1638 W US HIGHWAY 24
INDEPENDENCE MO
64050-2346
US

IV. Provider business mailing address

3801 BLUE PKWY
KANSAS CITY MO
64130-2807
US

V. Phone/Fax

Practice location:
  • Phone: 816-627-2000
  • Fax: 816-448-2925
Mailing address:
  • Phone: 816-923-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberPENDING
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: