Individual
DR. JAY FRANK BANISTER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4801 E LINWOOD BLVD, VA MED CENTER/MENTAL HYGIENE CLINIC, KANSAS CITY, MO 64128-2226
(816) 922-2641
(816) 922-4652
Mailing address
4801 E LINWOOD BLVD, VA MED CENTER/MENTAL HYGIENE CLINIC, KANSAS CITY, MO 64128-2226
(816) 922-2641
(816) 922-4652
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2008015998
MO
2084P0800X
Psychiatry Physician
Primary
2008015998
MO
Other
Enumeration date
03/30/2007
Last updated
04/09/2013
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