Healthcare Provider Details

I. General information

NPI: 1215016225
Provider Name (Legal Business Name): MICHAEL L. KASPER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 NW COMMERCE DR #102
LEES SUMMIT MO
64086-5703
US

IV. Provider business mailing address

12217 S SUMMIT
OLATHE KS
66062
US

V. Phone/Fax

Practice location:
  • Phone: 816-554-3646
  • Fax: 816-554-3607
Mailing address:
  • Phone: 913-379-7733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMO102949
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: