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Individual

DR. ANTHONY RAY JUSTESEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
20805 W 151ST ST, SUITE 200, OLATHE, KS 66061-7249
(913) 324-8571
Mailing address
20805 W 151ST ST, SUITE 200, OLATHE, KS 66061-7249
(913) 324-8571

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-28962
KS
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
04-28962
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100384140A
KS
Enumeration date
05/17/2006
Last updated
01/04/2022
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