Organization
CAPITOL PATHOLOGY SPECIALISTS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETTY SUE CAGLE MD (ANATOMIC PATHOLOGIST)
(202) 744-5124
Entity
Organization
Contact information
Practice address
2800 E ROCK HAVEN RD, HARRISONVILLE, MO 64701-4411
(816) 380-3474
Mailing address
2203 TWIN OAKS DR APT 67, HARRISONVILLE, MO 64701-2972
(202) 744-5124
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010326106
—
MO
05
—
100642360A
—
KS
05
—
11022900
—
WI
Enumeration date
05/30/2022
Last updated
06/20/2022
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