Individual
DR. JAY ALAN RISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12300 METCALF AVE, OVERLAND PARK, KS 66213-1324
(816) 932-2239
Mailing address
901 E 104TH ST, MS 400S, KANSAS CITY, MO 64131
(816) 502-8752
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
2086H0002X
Hospice and Palliative Medicine (Surgery) Physician
04-34116
KS
2086H0002X
Hospice and Palliative Medicine (Surgery) Physician
Primary
2008021950
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174505366
—
MO
05
—
200852540B
—
KS
Enumeration date
11/15/2005
Last updated
11/14/2017
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