Individual
DR. RICKY RAY RADAKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 CARONDELET DR, KANSAS CITY, MO 64114-4673
(816) 942-4400
Mailing address
5427 CENTRAL ST, KANSAS CITY, MO 64112-2829
(913) 214-2027
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
108556
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208498915
—
MO
01
—
24710013
BCBS OF KC MO
MO
01
—
930062972
RR MEDICARE GROUP CD1534
—
Enumeration date
08/30/2005
Last updated
12/30/2021
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