MEDICARE: CARL L FALCONE MD AN OPERATING DIVISION OF PROVIDENCE MEDICAL CTR

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	207Y00000X	Otolaryngology Physician	0432718	KS

General Provider Information

NPI Number	:	1861641680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARL L FALCONE MD AN OPERATING DIVISION OF PROVIDENCE MEDICAL CTR

Provider Business Mailing Address
First Line	:	PO BOX 12365
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66112-0365
Country	:	US
Telephone Number	:	913-825-6512
Fax Number	:	913-328-7011

Provider Business Practice Location Address
First Line	:	2300 HUTTON RD
Second Line	:	SUITE 106
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-4436
Country	:	US
Telephone Number	:	913-721-3387
Fax Number	:	913-721-3375

Authorized Official
Title or Position	:	CEO PROVIDENCE HEALTH
Name	:	MR. MICHAEL A DORSEY
Credential	:
Telephone Number	:	913-596-4000

Provider Enumeration Date	:	09/17/2008
Last Update Date	:	10/21/2008

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