Individual
DR. EUGENE H VANDENBOOM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 NE SAINT LUKES BLVD, SUITE 310, LEES SUMMIT, MO 64086-6001
(816) 282-7809
(816) 282-7870
Mailing address
20 NE SAINT LUKES BLVD, SUITE 310, LEES SUMMIT, MO 64086-6001
(816) 282-7809
(816) 282-7870
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R5C01
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201731213
—
MO
Enumeration date
06/05/2006
Last updated
09/01/2021
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