Individual
DR. CARL LEMAR VAN TASELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2800 CLAY EDWARDS DR, KANSAS CITY, MO 64116-3220
(913) 642-4900
(913) 381-0979
Mailing address
PO BOX 419380, KANSAS CITY, MO 64141-6380
(913) 642-4900
(913) 381-0979
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0432055
KS
2085R0202X
Diagnostic Radiology Physician
Primary
2008014396
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205986874
—
MO
05
—
200424020B
—
KS
01
—
40465019
BCBSKC & PHP
MO
01
—
P00640713
RR MEDICARE
MO
Enumeration date
01/12/2007
Last updated
08/16/2017
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