MEDICARE: DR. RITA C RODGERS STANLEY M.D.

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	207R00000X	Internal Medicine Physician	R9J37	MO

General Provider Information

NPI Number	:	1225149537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RITA C RODGERS STANLEY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 480
Second Line	:
City	:	SMITHVILLE
State	:	MO
Zip	:	64089-0480
Country	:	US
Telephone Number	:	816-444-6055
Fax Number	:	816-444-6033

Provider Business Practice Location Address
First Line	:	6650 TROOST AVE
Second Line	:	STE 205
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-1215
Country	:	US
Telephone Number	:	816-444-6055
Fax Number	:	816-444-6033

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/09/2007

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