Individual
DR. RODNEY JAMES MALISOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1504 NE 96TH ST STE A, LIBERTY, MO 64068-1351
(816) 415-2233
(816) 415-2218
Mailing address
1504 NE 96TH ST STE A, LIBERTY, MO 64068-1351
(816) 415-2233
(816) 415-2218
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2000146367
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205388101
—
MO
01
—
30006033
BLUE CROSS BLUE SHIELD
—
01
—
33106180464024A002
TRIWEST
—
Enumeration date
07/12/2005
Last updated
03/20/2026
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