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General NPI Number Information
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NPI Number | 1861985103
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Entity Type | Individual
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Provider Name | THOMAS M DAGG MD
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Gender | Male
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 18695 W 151ST ST
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City | OLATHE
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State | KS
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Zip | 66062-2738
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Country | US
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Telephone | 913-588-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 BROADWAY AVE
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City | GREAT BEND
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State | KS
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Zip | 67530-3633
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Country | US
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Telephone | 620-792-2511
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Fax | 620-860-0619
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 04-43925
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 94-09578
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License Number State | KS
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