Healthcare Provider Details

I. General information

NPI: 1801027743
Provider Name (Legal Business Name): COLE R SPRESSER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 03/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5325 FARAON ST
SAINT JOSEPH MO
64506-3488
US

IV. Provider business mailing address

5325 FARAON ST
SAINT JOSEPH MO
64506-3488
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-6406
  • Fax: 816-271-7986
Mailing address:
  • Phone: 816-271-6406
  • Fax: 816-271-7986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9407278
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2012011932
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2012011932
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: