Healthcare Provider Details

I. General information

NPI: 1023062643
Provider Name (Legal Business Name): ROBERT TIAN-RUN TUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 11/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 CARONDELET DR SUITE 200
KANSAS CITY MO
64114-4855
US

IV. Provider business mailing address

PO BOX 843769
KANSAS CITY MO
64184-3769
US

V. Phone/Fax

Practice location:
  • Phone: 816-941-7727
  • Fax: 816-941-7456
Mailing address:
  • Phone: 816-941-7727
  • Fax: 816-941-7456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberR3G95
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number0422298
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: