Individual
MR. CARL WESLEY FILLINGAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
19550 E 39TH ST S STE 230, INDEPENDENCE, MO 64057-2309
(816) 795-6630
(816) 795-6898
Mailing address
19550 E 39TH ST S STE 230, INDEPENDENCE, MO 64057-2309
(816) 795-6630
(816) 795-6898
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
MO
Other
Enumeration date
02/16/2017
Last updated
02/01/2022
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