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NPI Code Detail

MEDICARE: MARK B YAGAN M.D.

MEDICARE: MARK B YAGAN 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
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianMDR9N93MO
2207RC0200XCritical Care Medicine (Internal Medicine) Physician0425756KS
3207RP1001XPulmonary Disease Physician0425756KS
4207RP1001XPulmonary Disease PhysicianMDR9N93MO

General Provider Information

NPI Number : 1861493934
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK B YAGAN M.D.
Provider Business Mailing Address
First Line : 901 E. 104TH ST.
Second Line : MAILSTOP 400N
City : KANSAS CITY
State : MO
Zip : 64131-9712
Country : US
Telephone Number : 816-502-8752
Fax Number : 816-932-9670
Provider Business Practice Location Address
First Line : 4321 WASHINGTON ST
Second Line : SUITE 6000
City : KANSAS CITY
State : MO
Zip : 64111-5961
Country : US
Telephone Number : 816-756-2255
Fax Number : 816-931-4080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 11/17/2017

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