Individual
LARRY VAIL MCDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 NE 83RD ST, SUITE 1001, KANSAS CITY, MO 64119-4400
(816) 468-0400
(816) 468-6623
Mailing address
PO BOX 8580, PRAIRIE VILLAGE, KS 66208-0580
(913) 901-8223
(913) 901-0093
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
04-16410
KS
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
R6F27
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100152920C
—
KS
05
—
1568482453
—
MO
Enumeration date
07/20/2006
Last updated
06/13/2014
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