Healthcare Provider Details

I. General information

NPI: 1770801839
Provider Name (Legal Business Name): CHRISTOPHER J MAUGANS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 08/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 NE SAINT LUKE'S BOULEVARD SUITE 200
LEE'S SUMMIT MO
64086-2342
US

IV. Provider business mailing address

901 E 104TH ST # MS 400S
KANSAS CITY MO
64131-4517
US

V. Phone/Fax

Practice location:
  • Phone: 816-246-4302
  • Fax:
Mailing address:
  • Phone: 816-502-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2016008220
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number2016008220
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number2016008220
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: