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General NPI Number Information
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NPI Number | 1609921196
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Entity Type | Organization
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Legal Business Name | LUKE J DLABAL JR MD PC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 3601 NE RALPH POWELL RD SUITE C
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City | LEES SUMMIT
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State | MO
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Zip | 64064-2357
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Country | US
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Telephone | 816-347-1514
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Fax | 816-347-1822
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Provider Business Mailing Address
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Address Line | 3601 NE RALPH POWELL RD SUITE C
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City | LEES SUMMIT
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State | MO
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Zip | 64064-2357
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Country | US
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Telephone | 816-347-1514
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Fax | 816-347-1822
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | DR. LUKE JACOB DLABAL JR.
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Credential | MD
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Telephone | 816-347-1514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | M030680
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License Number State | MO
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