Healthcare Provider Details
I. General information
NPI: 1174587703
Provider Name (Legal Business Name): ARTURO G QUIASON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17221 E 23RD ST S #206
INDEPENDENCE MO
64057-1803
US
IV. Provider business mailing address
17221 E 23RD ST S #206
INDEPENDENCE MO
64057-1803
US
V. Phone/Fax
- Phone: 816-373-1911
- Fax:
- Phone: 816-373-1911
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0805X |
| Taxonomy | Geriatric Psychiatry Physician |
| License Number | R7577 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: