Individual
KRIS JAY FUCANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13013 FULLER AVE STE A, GRANDVIEW, MO 64030-2687
(816) 214-5548
Mailing address
13013 FULLER AVE STE A, GRANDVIEW, MO 64030-2687
(816) 214-5548
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2022014622
MO
Other
Enumeration date
07/23/2022
Last updated
07/23/2022
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