MEDICARE: DAVID R. GUSTAFSON DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	R9B87	MO

General Provider Information

NPI Number	:	1205817871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID R. GUSTAFSON DO

Provider Business Mailing Address
First Line	:	3507 SHADY BEND DR
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64052-2860
Country	:	US
Telephone Number	:	816-651-8631
Fax Number	:

Provider Business Practice Location Address
First Line	:	3507 SHADY BEND DR
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64052-2860
Country	:	US
Telephone Number	:	816-651-8631
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	04/22/2011

Similar Medicare Providers

1619975315 — ANNETTE M BECK MD
Practice Location Address:

11200 E WINNER RD
INDEPENDENCE, MO
64052-3964

Practice Phone: 816-836-4300
Practice Fax: 816-836-2118

1598757239 — DR. WAYNE LAWRENCE LETIZIA M.D.
Practice Location Address:

10010 E TRUMAN RD
INDEPENDENCE, MO
64052-2160

Practice Phone: 816-252-7800
Practice Fax: 816-252-3542

1407843618 — DR. LANA CAY PENNELL D.O.
Practice Location Address:

10707 E WINNER RD
INDEPENDENCE, MO
64052-3759

Practice Phone: 816-350-1100
Practice Fax:

1821034026 — WILLIAM T. BROWN JR. D.O.
Practice Location Address:

10010 E TRUMAN RD
INDEPENDENCE, MO
64052-2160

Practice Phone: 816-252-7800
Practice Fax: 816-252-3542

1437180171 — COCKERELL & MCINTOSH PEDIATRIC URGENT CARE PC
Practice Location Address:

11200 E WINNER RD
INDEPENDENCE, MO
64052-3964

Practice Phone: 816-252-9850
Practice Fax:

1356372270 — MS. AMELIA GAIL CLAUSEN LCSW
Practice Location Address:

12012 OAK RIDGE RD
INDEPENDENCE, MO
64052-2826

Practice Phone: 816-462-2953
Practice Fax:

Directions to “ DAVID R. GUSTAFSON DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.