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General NPI Number Information
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NPI Number | 1619532777
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Entity Type | Individual
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Provider Name | MUSTAFA HASAN AL-KHARSAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/04/2019
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 4000 CAMBRIDGE ST
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City | KANSAS CITY
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State | KS
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Zip | 66160-8501
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Country | US
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Telephone | 913-588-1227
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Fax | 505-272-6692
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Provider Business Mailing Address
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Address Line | 3901 RAINBOW BLVD MAILSTOP 2012
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City | KANSAS CITY
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State | KS
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Zip | 66160-0001
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Country | US
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Telephone | 913-588-6970
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Fax | 913-588-6965
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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 | 2084N0008X
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Taxonomy Name | Neuromuscular Medicine (Psychiatry & Neurology) Physician
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License Number | 2025032804
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 04-49550
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2025032804
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 2084N0008X
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Taxonomy Name | Neuromuscular Medicine (Psychiatry & Neurology) Physician
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License Number | 04-49550
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License Number State | KS
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