Individual
SCOTT R LUALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7900 LEES SUMMIT RD, KANSAS CITY, MO 64139-1236
(816) 404-7650
(816) 404-7612
Mailing address
2310 HOLMES ST STE 800, KANSAS CITY, MO 64108-2602
(816) 218-2500
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
04-23383
KS
207X00000X
Orthopaedic Surgery Physician
105477
MO
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
105477
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200027744
RAILROAD MEDICARE
KS
Enumeration date
08/18/2005
Last updated
03/17/2018
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