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Individual

DR. VANPRASEUTH FONGNALY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111
(816) 932-3679
(816) 932-9089
Mailing address
901 E 104TH ST, MAILSTOP 400S, KANSAS CITY, MO 64131
(816) 502-8782

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2014025191
MO
207L00000X
Anesthesiology Physician
Primary
3724
WI
207L00000X
Anesthesiology Physician
CDRH.0068942
CO
207L00000X
Anesthesiology Physician
D0068983
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
029695
KAISER COMMERCIAL NUMBER
CO
05
100257947
WI
05
9000206080
CO
Enumeration date
02/13/2007
Last updated
03/28/2025
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