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General NPI Number Information
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NPI Number | 1477540227
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Entity Type | Individual
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Provider Name | SANTOSH GEORGE M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 09/13/2018
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Provider Practice Location Address
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Address Line | 2521 GLENN HENDREN DR SUITE 204
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City | LIBERTY
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State | MO
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Zip | 64068-3388
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Country | US
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Telephone | 816-781-6066
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Fax | 816-792-5130
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Provider Business Mailing Address
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Address Line | 2609 GLENN HENDREN DR
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City | LIBERTY
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State | MO
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Zip | 64068-3313
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Country | US
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Telephone | 816-407-4555
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Fax | 816-407-2362
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 2002010575
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License Number State | MO
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