Individual
GARTH R FRAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Mailing address
2401 GILLHAM RD, ATTN PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 701-5200
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0426780
KS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2000153499
MO
207ZP0213X
Pediatric Pathology Physician
Primary
2000153499
MO
Other
Enumeration date
10/27/2005
Last updated
04/30/2026
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