Organization
COLORECTAL SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM CARMEN CIROCCO MD (OWNER)
(913) 831-1900
Entity
Organization
Contact information
Practice address
8901 W 74TH ST, #148, SHAWNEE MISSION, KS 66204
(913) 831-1900
(913) 831-1999
Mailing address
8901 W 74TH ST, #148, SHAWNEE MISSION, KS 66204
(913) 831-1900
(913) 831-1999
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
0424933
KS
208C00000X
Colon & Rectal Surgery Physician
105102
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007494A
—
KS
Enumeration date
11/07/2006
Last updated
08/22/2020
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