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Individual

DR. LANCER GENTRY GATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2750 CLAY EDWARDS DR STE 200A, NORTH KANSAS CITY, MO 64116-3237
(816) 968-9320
Mailing address
2750 CLAY EDWARDS DR STE 200A, N KANSAS CITY, MO 64116-3237
(816) 968-9320

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2000174342
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200304460A
KS
05
245309117
MO
01
28043027
BLUE SHIELD KANSAS CITY
MO
01
5400729
AETNA
MO
Enumeration date
07/06/2005
Last updated
11/05/2007
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