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NPI Code Detail

MEDICARE: DR. TODD ALAN STASTNY M.D.

MEDICARE: DR. TODD ALAN STASTNY 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
1208D00000XGeneral Practice PhysicianR2J77MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080167543OTHERMOMEDICARE RAILROAD

General Provider Information

NPI Number : 1316002975
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TODD ALAN STASTNY M.D.
Provider Business Mailing Address
First Line : 1920 NW 2ND ST
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64014-1702
Country : US
Telephone Number : 816-228-3659
Fax Number :
Provider Business Practice Location Address
First Line : 400 SW LONGVIEW BLVD STE 200
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64081-2116
Country : US
Telephone Number : 913-215-5008
Fax Number : 913-297-1202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2006
Last Update Date : 11/20/2023

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Directions to “ DR. TODD ALAN STASTNY M.D.” Practice Location

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