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NPI Code Detail

MEDICARE: MR. JASON JOEL DOHRING BA

MEDICARE: MR. JASON JOEL DOHRING BA
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
1183500000XPharmacist045210MO

General Provider Information

NPI Number : 1881957157
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JASON JOEL DOHRING BA
Provider Business Mailing Address
First Line : 28250 W 119TH ST
Second Line :
City : OLATHE
State : KS
Zip : 66061-9013
Country : US
Telephone Number : 314-406-1544
Fax Number :
Provider Business Practice Location Address
First Line : 9430 BLUE RIDGE BLVD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64138-3846
Country : US
Telephone Number : 816-765-5279
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2012
Last Update Date : 06/20/2012

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